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.

* 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.

Research increasingly suggests that addiction has a genetic and neurobiological basis, but efforts to translate research into effective clinical treatments and social policy needs to be informed by careful ethical analyses of the personal and social implications. Scientists and policy makers alike must consider possible unintended negative consequences of neuroscience research so that the promise of reducing the burden and incidence of addiction can be fully realized and new advances translated into clinically meaningful and effective treatments. This volume brings together leading addiction researchers and practitioners with neuroethicists and social scientists to specifically discuss the ethical, philosophical, legal and social implications of neuroscience research of addiction, as well as its translation into effective, economical and appropriate policy and treatments. Chapters explore the history of ideas about addiction, the neuroscience of drug use and addiction, prevention and treatment of addiction, the moral implications of addiction neuroscience, legal issues and human rights, research ethics, and public policy.

The question of whether abortion should or should not be permitted, and under what circumstances, is among the most difficult and sometimes anguished decisions for contemporary men and women. How we feel about this issue, and what actions we take, help to define our image of who we are as social beings. In the midst of the surrounding political, ethical, and religious debate, people everywhere are once again examining their conscience and their beliefs, and turning to unutilized sources of information as they seek to come to terms with this contentious issue. And as emotions run high, it is helpful to step back from the highly charged arena to reconsider the underlying scientific facts about human development.
In The Facts of Life, Harold Morowitz and James Trefil, two distinguished scientists and science writers, examine what modern biology can contribute to our understanding of this debate. Sensitive to the myriad ethical and religious arguments beyond the realm of science that swirl around abortion, the authors focus on one crucial question--when does a fetus acquire "humanness," that quality that sets us apart from all other living things. From the viewpoint of science, they argue, "humanness" begins with the possession of a highly developed cerebral cortex. While humans are linked via cell structure and cell chemistry with all life on our planet--from monkeys to fruit flies to pumpkins--it is the human brain structure which makes us who we are. Reviewing the latest advances in molecular biology, evolutionary biology, embryology, neurophysiology, and neonatology--fields that all bear on this question--the authors reveal a surprising consensus of scientific opinion on when humanness begins.
A lucid primer on the biological aspects of the abortion issue, The Facts of Life is also a fascinating inquiry, across various scientific disciplines, into what makes us uniquely human. Anyone who struggles with the issue of abortion will be grateful to find a work that moves this heated issue from the intensely emotional area it has occupied to the calmer domain of science.

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

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.

* Helps readers become proficient ethical decision-makers using the 2020 NASP ethical code and to critically engage the ethical standards and work through ethical dilemmas that often occur in school and clinical settings * Over 100 ethical case studies are presented in the text that specifically relate to NASP's Principles for Professional Ethics * Readers are provided step-by-step directions on how to use the ethical decision-making model when problem solving each case scenario

* Helps readers become proficient ethical decision-makers using the 2020 NASP ethical code and to critically engage the ethical standards and work through ethical dilemmas that often occur in school and clinical settings * Over 100 ethical case studies are presented in the text that specifically relate to NASP's Principles for Professional Ethics * Readers are provided step-by-step directions on how to use the ethical decision-making model when problem solving each case scenario

The phenomenon of the New Genetics raises complex social problems, particularly those of privacy. This book offers ethical and legal perspectives on the questions of a right to know and not to know genetic information from the standpoint of individuals, their relatives, employers, insurers and the state. Graeme Laurie provides a unique definition of privacy, including a concept of property rights in the person, and argues for stronger legal protection of privacy in the shadow of developments in human genetics. He challenges the role and the limits of established principles in medical law and ethics, including respect for patient autonomy and confidentiality. This book will interest lawyers, philosophers and doctors concerned both with genetic information and issues of privacy; it will also interest genetic counsellors, researchers, and policy makers worldwide for its practical stance on dilemmas in modern genetic medicine.

Does a competent person suffering from a terminal illness or enduring an otherwise burdensome existence, who considers his life no longer of value but is incapable of ending it, have a right to be helped to die? Should someone for whom further medical treatment would be futile be allowed to die regardless of expressing a preference to be given all possible treatment? These are some of the questions that are asked and answered in this wide-ranging discussion of both the morality of medically assisted death and the justifiability of making certain instances legal. A case is offered in support of the moral and legal permissibility of specified instances of medically assisted death, along with responses to the main objections that have been levelled against it. The philosophical argument is bolstered by empirical evidence from The Netherlands and Oregon where voluntary euthanasia and physician-assisted suicide are already legal.

This book addresses selected violations of professional nursing conduct and practices that take place in shadows or on the margins of clinical practice-incidents that represent "dark" or "gray" areas of nursing. Chapters identify threats to patient and nurse well-being that are antithetical to nurses' principles; sensitize nurses and other stakeholders to gray and dark sides of nursing through case examples; and pose evidence-based solutions for eliminating, mitigating, and addressing examples representing the gray or dark side of nursing. The book encourages organizations to promote a culture of ethical responsibility for nursing practices.

In 1985, philosopher Samuel Gorovitz spent seven weeks at Boston's Beth Israel, one of the nation's premier teaching hospitals, where he was given free run as "Authorized Snoop and Irritant-at-Large." In Drawing the Line, he provides an intense, disturbing, and insightful account of his observations during those seven weeks.
Gorovitz guides us through an operating room and intensive care units, and takes us to meetings where surgeons discuss the mishaps of the preceding week, where internists map out their approaches to troublesome cases, where the administration discusses competition in the health care market. He follows as residents walk the ragged edge of physical exhaustion, as experienced physicians wrestle with the uncertainties of their demanding profession, as nurses struggle to care for perpetually declining patients. Most important, he examines the ethical questions that permeate their lives--deeply troubling questions such as who should be making life and death decisions--and how should they be made? How should scarce medical resources be allocated? What rules should govern the use of fetal tissue in research and treatment? Where should we draw the line, and how?
When Samuel Gorovitz published Doctors' Dilemmas, a previous look at medical ethics, it was hailed by Norman Cousins as "stimulating and valuable...the product of a beautifully formed (and informed) mind." Studs Terkel called it "quite remarkable...a very exciting book indeed." In Drawing theLine, Gorovitz offers an unusual look at contemporary health care, combining a moving, hard-hitting glimpse of daily reality at a major hospital with the thoughtful, provocative reflections of a highly respected philosopher.

This timely book analyses and evaluates ethical and social implications of recent developments in reporting surgeon performance. It contains chapters by leading international specialists in philosophy, bioethics, epidemiology, medical administration, surgery, and law, demonstrating the diversity and complexity of debates about this topic, raising considerations of patient autonomy, accountability, justice, and the quality and safety of medical services. Performance information on individual cardiac surgeons has been publicly available in parts of the US for over a decade. Survival rates for individual cardiac surgeons in the UK have recently been released to the public. This trend is being driven by various factors, including concerns about accountability, patients??? rights, quality and safety of medical care, and the need to avoid scandals in medical care. This trend is likely to extend to other countries, to other clinicians, and to professions beyond health care, making this text an essential addition to the literature available.

This open access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts are underway to more formally "professionalize" the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of "peer-reviews": critique of the actions of the case scenario's ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking.

As one of the most massive and successful business sectors, the pharmaceutical industry is a potent force for good in the community, yet its behaviour is frequently questioned: could it serve society at large better than it has done in the recent past? Its own internal ethics, both in business and science, may need a careful reappraisal, as may the extent to which the law - administrative, civil and criminal - succeeds in guiding (and where neccessary contraining) it.
The rules of behavior that may be considered to apply to today's pharmaceutical industry have emerged over a very long period and the process goes on. Even the immensely detailed standards for quality, safety and efficacy laid down in drug law and regulation during the second half of the twentieth century have their limitations as tools for ensuring that the public interest is well served. In particular, national and regional regulatory agencies are heavily dependent on industrial data for their decision-making, their standards and competence vary, and even the existing network of agencies does not cover the entire world. What is more there are many areas of law and regulation affecting the industry, concerning for example the pricing of medicines, the conduct of clinical studies, the health protection of workers and concern for the environment. In some fields it is indeed hardly possible to maintain standards through regulation.
Professor N.M. Graham Dukes, a physician and lawyer with long term experience in industrial research management, academic study and international drug policy, provides here a powerfully documented analysis into the way this industry thinks, acts, and is viewed, and examines the current trends pointing to change.
*Provides a balanced picture of the current role of the pharmaceutical industry in society
*Includes indices of conventions, laws, and regulations; as well as judicial and disciplinary cases
*This is the only book addressing the legal implications of big pharma activities and ethical standards

The Medical Biobank of Umea in Sweden, deCODE's Health Sector Database in Iceland, the Estonian Genome Project and the UK Biobank contain health data and genetic data from large populations. Some include genealogical or lifestyle information. They are resources for research in human genetics and medicine, exploring interaction between genes, lifestyle, environmental factors and health and diseases. The collection, storage and use of this data raise ethical, legal and social issues. In this book, first published in 2007, bioethics scholars examine whether existing ethical frameworks and social policies reflect people's concerns, and how they may need to change in light of new scientific and technological developments. The ethical issues of social justice, genetic discrimination, informational privacy, trust in science and consent to participation in database research are analyzed, whilst an empirical survey, conducted in the four countries, demonstrates public views of privacy and related moral values in the context of human genetic databases.

In one form or another, health care now gets rationed. Not everything beneficial is done for every patient. For the individual the consequences are sometimes tragic. Rationing decisions thus raise a classic dilemma: how can we treat with dignity and genuine respect the person who gets short-changed by an efficient policy that seems best overall? Strong Medicine argues that we can, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients as well as the doctor ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperiled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers interested in policy questions the book takes up. The issues are fascinating, the arguments are careful, and the results often surprising.

How, in a secular world, should we resolve ethically controversial and troubling issues relating to health care? Should we, as some argue, make a clean sweep, getting rid of the Hippocratic ethic, such vestiges of it as remain? Jennifer Jackson seeks to answer these significant questions, establishing new foundations for a traditional and secular ethic which would not require a radical and problematic overhaul of the old.

These new foundations rest on familiar observations of human nature and human needs. Jackson presents morality as a loose anatomy of constituent virtues that are related in different ways to how we fare in life, and suggests that in order to address problems in medical ethics, a virtues-based approach is needed. Throughout, attention is paid to the role of philosophy in medical ethics, and how it can be used to clarify key notions and distinctions that underlie current debates and controversial issues. By reinstating such concepts as justice, cardinal virtue, and moral duty, Jackson lays the groundwork for an ethics of health care that makes headway toward resolving seeming dilemmas in medical ethics today.

This penetrating and accessible book will be invaluable to students of sociology and health care, as well as those who are interested in the ethical uncertainties faced by the medical world.

This book studies the critical issues that dominate contemporary discourse on biomedical ethics. It brings together various debates highlighting the historical, philosophical, scientific and technological perspectives involved in modern medicine in different societies, with a focus on contemporary medicine in India. The volume provides a comprehensive look into the origin and evolution of bioethics with an examination of how complex bioethical issues are negotiated in different contexts. The author traces the transition from traditional to modern bioethics and examines important bioethical frameworks to deal with moral dilemmas and challenges. He also contemplates the future of bioethics with an emphasis on regulation in practice to prevent repression and exploitation in medicine. A comprehensive study of contemporary approaches to bioethics, the book will be indispensable for students, professionals and researchers in public health, ethics, biomedical ethics, medicine, philosophy, sociology, public policy and anthropology.

This book examines the regulatory framework for untested and unapproved uses (off-label uses) of medicines in the EU, UK, and USA. Before reaching patients, medicines are extensively tested by manufacturers and approved by regulators to minimise the risk of adverse reactions. However, physicians can prescribe pharmaceuticals for off-label uses, widespread in paediatrics, oncology, rare diseases and, more recently, in treatment for Covid-19. While off-label uses may offer hope, they may also expose patients to risks and uncertainties. Clarification is therefore needed to improve the protection of patients' rights while enhancing legal certainty for health actors. To this end, this work clarifies the regulatory mechanisms and litigation trends concerning off-licence prescriptions in these jurisdictions. It assesses how traditional, prevention-driven regulatory and civil liability rules are being adapted to tackle potential risks and scientific uncertainty. The book outlines the applicable regulations, as well as considering Brexit's impact on off-label policies in the UK, and EU and national off-label policies in the context of the fight against the Covid-19 pandemic. It also explores under what conditions physicians, manufacturers, or regulators must compensate patients injured by untested prescriptions. The book will be an essential resource for researchers, academics and policy-makers working in the areas of medical law and ethics, public health law, pharmaceutical law and private comparative law.

In the following essays discussing clinical ethics consultation, three sorts of reflective writing are presented. The first is a description of a clinical ethics consultation, more generously detailed than most that have been published, yet obviously limited as a documentation of the experiences at its source. It is followed by three examples of a second kind in the probing commentaries by highly regarded figures in biomedical and clinical ethics - Francois Baylis, Tom Tomlinson, and Barry Hoffmaster. Finally, these are followed by a third variety of reflection in the form of responses to those three commentaries, by Bilton and Stuart G. Finder, and my Afterword - a further reflection on some of the issues and questions intrinsic to clinical ethics consultation and to these various essays. The consultation itself was conducted by Bliton; but Finder not only assisted at one point (he is the colleague' mentioned in Bliton's manuscript) but frequently participated in the discussions that are invariably part of our clinical ethics consultative practice in our Center for Clinical and Research Ethics at Vanderbilt University Medical Center. It was thus natural for Finder to participate in the response. Each of these essays is fascinating and important on its own; together, however, they constitute a truly unusual and, we believe, very significant contribution that will hopefully figure prominently in subsequent discussions, and in shaping and deepening an endeavor - clinical ethics - still in much-needed search of its own discipline, method rationale and place in the domain of clinical practice more generally. This group of essays is also quite unique, addressing as it does the coherence of a form of practice - and, it must be emphasized, several forms of writing about as well as theoretical proposals for understanding that practice - whose current and future character remains very much in contention. That a situation such as the one discussed here often provokes strong and passionate responses will be no surprise &endash; whether because of its relative novelty, its risky nature, the high stakes involved, or something else. It is in any event a striking feature of ethics consultations that the people directly or even indirectly involved tend at times to feel rather passionately about what is said (and not said), what is done (and not done), and what is then reported (or, it may be, left out). Even so, such energetic feelings, much less the candor of my colleague's response to such passion, are rarely if ever apparent from published reports. For this reason alone, a considerable debt of gratitude is surely owed to our commentators &endash; reflective and deliberative, yet passionate and forceful as each of them are."

In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence (re-interpreted as beneficence-in-trust) to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient's values. In order to act in the patient's best interests, or the patient's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician-patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today.

This book provides extensive and critical engagement with some of the most recent and compelling arguments favoring abortion choice. It features original essays from leading and emerging philosophers, bioethicists and medical professionals that present philosophically sophisticated and novel arguments against abortion choice.