As a society, we are faced with a series of dilemmas-abortion, euthanasia, genetic engineering, organ transplant allocation, support or non-support of the elderly and fragile-that seem to offer no resolution. How do we choose between the needy and the ailing? Choices must be made in both the world of law and the realm of medical ethics. What we need is what we do not have-a perspective in the larger sense of the word-a view that makes apparent the sweep of the issues at hand. The failure of perspective in bioethics and medical decision making is absolute. It results from the limits of an 18th century philosophy and philosophical method. Simply, current methods of examining these issues can not resolve them because the method itself is limited. Answers are possible. They require, Koch argues, a new approach. In it, principle is the goal, not the mechanism of solution. Its parts must be defined and their application considered in context. This is demonstrated using two distinct contemporary problems. The first: Who gets available organ transplants? How do we decide between the equally needy when there are not enough organs for all? The second: The problem of Baby K, the care or non-care of brain stem, anencephalic babies. These problems are defined using multicriterion approach and resolved through a series of focus group discussions that involve medical and lay personnel. What results is a new, more inclusive view of medicine and a new, more complex understanding of what consensus may mean in an evolving, twenty-first century society. This is must reading for lay people, medical personal, and policymakers concerned with bioethics and medical philosophy issues.

This bibliography presents studies of nonmedical factors (patient, clinician, and practice variables) that influence medical decision-making. Those factors include age, gender and presentational style of the patient; age, years in practice and attitudes of the clinician; and geographical location and list size of the practice. The authors separate such factors into two cateogories. The first is decision-making in the context of general patient management, such as test-ordering, diagnoses, and treatment recommendations. The second category is decision-making in the context of referrals made by generalists to specialists. Each published study identified from an extensive literature search is presented in a structured tabular format, with a brief summary of the study features described above. The studies cited were published in years spanning 1980 to March, 2001.

Researchers and clinicians, as well as graduate and postgraduate students, in all medical disciplines will find this volume of interest, as will health psychologists, health economists and social psychologists. This work integrates published research about medical decision-making that has earlier only been fragmented and spread across a variety of journals. A chapter on methodological considerations in medical decision-making research and a chapter on models of medical decision-making are included.

Ethical Problems and Genetics Practice provides a rich, case-based account of the ethical issues arising in the genetics clinic and laboratory. By analysing a wide range of evocative and often arresting cases from practice, Michael Parker provides a compelling insight into the complex moral world of the contemporary genetics professional and the challenges they face in the care of patients and their families. This book is essential reading for anyone interested in the ethical issues arising in everyday genetics practice. Ethical Problems and Genetics Practice is also a sustained engagement with the relationships between bioethics and social science. In proposing and exemplifying a new approach to bioethics, it makes a significant contribution to debates on methods and interdisciplinarity and will therefore also appeal to all those concerned with theoretical and methodological approaches to bioethics and social science.

This volume collects essays by the late bioethicist John D. Arras, best known for his many contributions to the methodology of bioethics. Always open-minded, Arras did not favor a single theory or view of method in bioethics, eschewing labels such as "casuist" or "pragmatist." He was conversant with the main philosophical methods that have dominated bioethics since the field's origin, including principlism, Gert's common morality, the "new casuistry", pragmatism, and others. Rather than defending any particular theory or method, though, Arras rigorously investigated those methods - and how they both expand and limit our field of vision. He sought, in the tradition of Kierkegaard, to make life "harder" for bioethics, by uncovering challenges to the field's analytical methods. His favorite mode of exploration and expression was the thoughtful essay. The essays collected here reveal him thinking through new problems and new possibilities, and they invariably yield fresh and valuable insights.

What are the moral challenges that confront doctors as they manage healthcare institutions? How do we build trust in medical organisations? How do we conceptualize moral action? Based on accounts given by senior doctors from organisations throughout the UK, this book discusses the issues medical leaders find most troubling and identifies the moral tensions they face. Moral Leadership in Medicine examines in detail how doctors protect patients' interests, implement morally controversial change, manage colleagues in difficulty and rebuild trust after serious medical harm. The book discusses how leaders develop moral narratives to make sense of these situations, how they behave while balancing conflicting moral goals and how they influence those around them to do the right thing in difficult circumstances. Based on empirical ethical analysis, this volume is essential reading for clinicians in leadership roles and students and academics in the fields of healthcare management, medical law and healthcare ethics.

This volume proposes a move away from the universalized and general modern ethical method, as it is currently practiced in biomedical ethics, while aiming toward a decision making process rooted in an ontology of relationality. Moyse uses the theological ethics of Karl Barth, in conversation with a range of thinkers, to achieve this turn.

Psychiatry Under the Influence investigates the actions and practices of the American Psychiatric Association and academic psychiatry in the United States, and presents it as a case study of institutional corruption.

The essays in Where's the Evidence? focus on problems ignored. This book is a unique collection of critical andw controversial essays on intractable ethical issues and evidence-based problems in modern medicine. Most, but notr therapeutic disasters. Although it is impossible to prevent all missteps in medicine, the author argues, a hedging strategy using concurrent controls when new therapies are introduced always reduces the number of patients killed or injured. It is dangerous to use treatments widely, he warns, before they are subject to rigorous comparative trials. Additionally, the author points out, questions have emerged about how to wield medicine's new capabilities wisely. How do we draw the line,' he asks 'between "knowing" (the acquisition of new medical information) and "doing" (the application of that new knowledge). What are the long- term consequences (moral, social, economic, and biological) of responding to a demand that medicine always do everything that can be done?' This book now issued in paperback is a collection of critical and controversial essays discussing intractable ethical issues and evidence-based problems in modern medicine. The essays together with responses were published over a ten-year period in the journal Paediatric and Perinatal Medicine. Most of the examples, but not all are taken from perinatal medicine, the field in which the author has worked for many years. The essays are thought provoking and will be of great interest to those involved in the ongoing evidence-based medicine debate. (See selected reviews)

This open access book presents an ethical approach to utilizing personal medical data. It features essays that combine academic argument with practical application of ethical principles. The contributors are experts in ethics and law. They address the challenges in the re-use of medical data of the deceased on a voluntary basis. This pioneering study looks at the many factors involved when individuals and organizations wish to share information for research, policy-making, and humanitarian purposes. Today, it is easy to donate blood or even organs, but it is virtually impossible to donate one's own medical data. This is seen as ethically unacceptable. Yet, data donation can greatly benefit the welfare of our societies. This collection provides timely interdisciplinary research on biomedical big data. Topics include the ethics of data donation, the legal and regulatory challenges, and the current and future collaborations. Readers will learn about the ethical and regulatory challenges associated with medical data donations. They will also better understand the special nature of using deceased data for research purposes with regard to ethical principles of autonomy, beneficence, and justice. In addition, the contributors identify the key governance issues of such a scheme. The essays also look at what we can learn in terms of best practice from existing medical data schemes.

Recent developments in biotechnology and genetic research are raising complex ethical questions concerning the legitimate scope and limits of genetic intervention. As we begin to contemplate the possibility of intervening in the human genome to prevent diseases, we cannot help but feel that the human species might soon take biological evolution into its own hands. In this important new book, Jurgen Habermas--the most influential philosopher and social thinker in Germany today--takes up the question of genetic engineering and its ethical implications and subjects it to careful philosophical scrutiny. Habermas's analysis is guided by the view that genetic manipulation is closely tied to the identity and self-understanding of the species. Habermas is particularly concerned with the question of how the biotechnological blurring of the distinction between the "grown" and the "made" may change our ethical self-understanding both as members of the species and as individuals. We cannot rule out the possibility that knowledge of one's own heredity will restrict individual freedom and undermine the symmetrical relations between free and equal human beings. In the concluding chapter--which was delivered as a lecture on receiving the Peace Prize of the German Book Trade for 2001--Habermas broadens the discussion to examine the tension between science and religion in the modern world, a tension that exploded with tragic violence on September 11, 2001.

This book explores, through case studies, the interplay between religion, culture, government, and politics in diverse societies on questions arising in the domain of bioethics. The case studies draw from multiple disciplinary perspectives, including history, theology, law, bioethics, public policy, science, and medicine. The text's global perspective permits a comparison of the differing approaches adopted by countries facing similar bioethical quandaries and the extent to which religion has or has not been instrumental in addressing such dilemmas. Secular and religious societies across the globe are being confronted with complex questions involving religious belief and the extent to which specific religious perspectives have in the past or should in the future be adopted as official policy. Bioethical issues involving the interplay of religion and government have become particularly notable in recent years. How these issues are resolved has major implications for individuals, healthcare providers, and the future of medical research and medical care. Topics explored among the chapters include: Homosexuality: Sin, Crime, Pathology, Identity, Behavior Medical Error: Truthtelling, Apology, and Forgiveness Refusal of Medical Treatment Medical Deportation Case Study: Nazism, Religion, and Human Experimentation The New Frontier: Cloning Case Studies in Society, Religion, and Bioethics will find an engaged audience among researchers and scholars in history, religion/theology, medicine, and bioethics interested in the influence of religion on bioethical decision-making. Students-particularly upper-level undergraduate and graduate students interested in bioethics, humanities, and theology-will find the text helpful in understanding the processes through which religion may serve as a basis for both societal policy and law and individual decision-making in health-related matters.

Ectogenesis refers to the artificial gestation of a fetus outside the womb. Despite certain advantages for women's reproductive liberty, feminist groups remain divided regarding this technology. This book argues that reproduction imposes unjust burdens on women, and thus the ideals of equal opportunity demand continued research into ectogenesis.

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.

First published in 1967, Human Guinea Pigs is a report by a consultant physician on the implications of medical research on both the medical profession and on the men, women and children who are the subjects of medical experiments. It suggests that there are limits to the permissibility of experiments on humans. It points out how it has become a common occurrence for medical investigators to take risks with patients of which the patients themselves are frequently unaware, and to submit them to mental and physical distress and possible hazards which in no way are necessitated by or have connection with the treatment of the disease from which are suffering. The author describes a number of experiments which, in his opinion, raise important problems. In his view, medical research must go on, but there must be acknowledged and observed safeguards for patients. This book will be of interest to students of medicine, ethics, law, politics and social work.

During the last thirty years we have witnessed sweeping changes in health care worldwide, including new and expensive biomedical technologies, an increasingly powerful and influential pharmaceutical industry, steadily increasing health care costs in industrialised nations, and new threats to medical professionalism. The essays collected in this book concern costs and profits in relation to just health care, the often controversial practices of pharmaceutical companies, and corruption in the professional practice of medicine. Leading experts discuss justice in relation to business-friendly strategies in the delivery of health care, access to life saving drugs, the ethics of pharmaceutical company marketing practices, exploitation in drug trials, and undue industry influence over medicine. They offer guidance regarding the ethical delivery of health care products and services by profit-seeking organisations operating in a global marketplace, and recommend pragmatic solutions to enhance organisational integrity and curb medical corruption in the interest of patient welfare.

The History and Bioethics of Medical Education: "You've Got to Be Carefully Taught" continues the Routledge Advances in the History of Bioethics series by exploring approaches to the teaching of bioethics from disparate disciplines, geographies, and contexts. Van Rensselaer Potter coined the phrase "Global Bioethics" to define human relationships with their contexts. This and subsequent volumes return to Potter's founding vision from historical perspectives and asks, how did we get here from then? The patient-practitioner relationship has come to the fore in bioethics; this volume asks: is there an ideal bioethical curriculum? Are the students being carefully taught and, in turn, are they carefully learning? This volume will appeal to those working in both clinical medicine and the medical humanities, as vibrant connections are drawn between various ways of knowing.

This collection addresses whether ethicists, like authorities in other fields, can speak as experts in their subject matter. Though ethics consultation is a growing practice in medical contexts, there remain difficult questions about the role of ethicists in professional decision-making. Contributors examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, how one might become a moral expert, and the trustworthiness of moral testimony. This volume engages with the growing literature in these debates and offers new perspectives from both academics and practitioners. The readings will be of particular interest to bioethicists, clinicians, ethics committees, and students of social epistemology. These new essays promise to advance discussions in the professionalization and accreditation of ethics consultation.

Increasingly digital technologies are used in healthcare. This book explores eight digital health technologies, situated the context of a life span, from high-throughput genomic sequencing technologies and do-it-yourself (DIY) insulin delivery for diabetes management in paediatrics, to the use of robotic care assistants for older adults and digital advance care decisions. A scene-setting case scenario at the start of each chapter describes the digital technology and identifies the sometimes competing interests of the key stakeholders. Broad themes of resource allocation, access to technologies, informed consent, privacy of health data and ethical concerns are considered in context, alongside analysis of legal duties owed by healthcare professionals to act in their patients' best interests. This book addresses legal and ethical issues arising from the use of emerging digital health technologies and is of interest to academics, clinicians and regulators and anyone interested in the development of health technologies and the challenges they may present. It focusses on the Australian legal framework, with some comparison to other jurisdictions.

Increasingly digital technologies are used in healthcare. This book explores eight digital health technologies, situated the context of a life span, from high-throughput genomic sequencing technologies and do-it-yourself (DIY) insulin delivery for diabetes management in paediatrics, to the use of robotic care assistants for older adults and digital advance care decisions. A scene-setting case scenario at the start of each chapter describes the digital technology and identifies the sometimes competing interests of the key stakeholders. Broad themes of resource allocation, access to technologies, informed consent, privacy of health data and ethical concerns are considered in context, alongside analysis of legal duties owed by healthcare professionals to act in their patients' best interests. This book addresses legal and ethical issues arising from the use of emerging digital health technologies and is of interest to academics, clinicians and regulators and anyone interested in the development of health technologies and the challenges they may present. It focusses on the Australian legal framework, with some comparison to other jurisdictions.

Few would question the necessity of artificial limbs for amputees. But what of surgery to lengthen the legs of children who are merely shorter than average? Hardly anyone would challenge the decision to prescribe Aricept to people with dementia. But is it acceptable to give the same medication to airline pilots seeking sharper mental focus on long-haul flights?

Humans have engaged in biological self-improvement since long before recorded history, from the impotence-curing wild lotus brew of the ancient Egyptians to the herbal energy drink favored by early Olympians. Now biomedical enhancements are pushing the boundaries of possibility and acceptability. Where do we draw the line? How do we know the true ramifications of pioneering medicine? What price are we willing to pay for perfection?

Maxwell J. Mehlman's provocative examination of these issues speaks to fundamental questions of what it means to be human. He finds public officials ill-equipped to handle the ethical, scientific, and public policy quandaries of biomedical enhancement. Instead of engaging difficult questions of morality, access, fairness, and freedom, elected officials have crafted toothless and counterproductive laws and regulations.

Mehlman outlines policy options to boost the societal benefits and minimize the risks from these technologies. In the process, he urges the public to face the ethical issues surrounding biomedical enhancement, lest our quest for perfection compromise our very humanity.

Drawing on the findings of a series of empirical studies undertaken with boards of directors and CEOs in the United States, this groundbreaking book develops a new paradigm to provide a structured analysis of ethical healthcare governance. Governance Ethics in Healthcare Organizations begins by presenting a clear framework for ethical analysis, designed around basic features of ethics - who we are, how we function, and what we do - before discussing the paradigm in relation to clinical, organizational and professional ethics. It goes on to apply this framework in areas that are pivotal for effective governance in healthcare: oversight structures for trustees and executives, community benefit, community health, patient care, patient safety and conflicted collaborative arrangements. This book is an important read for all those interested in healthcare management, corporate governance and healthcare ethics, including academics, students and practitioners.

* The book is balanced and comprehensive, recognising that both affordability and investment into innovation are necessary * The book is original, using ecological concepts to understand pharmaceutical innovation as an ecosystem. * The book is unique in its research foundation, building on the views of more than 70 expert informants from all parts of the pharmaceutical innovation ecosystem and all sides of the debate about drug pricing.

* The book is balanced and comprehensive, recognising that both affordability and investment into innovation are necessary * The book is original, using ecological concepts to understand pharmaceutical innovation as an ecosystem. * The book is unique in its research foundation, building on the views of more than 70 expert informants from all parts of the pharmaceutical innovation ecosystem and all sides of the debate about drug pricing.

First book to examine the ethics of pandemics from a philosophical standpoint Examines the key and controversial issues that arise out of pandemics, such as government response, test and trace, restrictions on human freedom and movement and vaccine passports Very useful reading for those in related fields such as medicine and health care as well as applied ethics within philosophy Case studies from UK, south east Asia, US and Europe

First book to examine the ethics of pandemics from a philosophical standpoint Examines the key and controversial issues that arise out of pandemics, such as government response, test and trace, restrictions on human freedom and movement and vaccine passports Very useful reading for those in related fields such as medicine and health care as well as applied ethics within philosophy Case studies from UK, south east Asia, US and Europe