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Books > Medicine > General issues > Medical ethics
This Open Access book highlights the ethical issues and dilemmas that arise in the practice of public health. It is also a tool to support instruction, debate, and dialogue regarding public health ethics. Although the practice of public health has always included consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. There are few practical training resources for public health practitioners, especially resources which include discussion of realistic cases which are likely to arise in the practice of public health. This work discusses these issues on a case to case basis and helps create awareness and understanding of the ethics of public health care. The main audience for the casebook is public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook is also useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.
The wealth of insights into the brain 's functioning gained by neuroscience in recent years led to the development of new possibilities for intervening in the brain such as neurotransplantation, neural prostheses and brain stimulation techniques. Moreover, new and safer classes of psychopharmaceutical drugs lend themselves to neuroenhancement applications, i.e. they could be used to enhance cognitive capacities or emotional well-being without therapeutic need. This book offers extensive state-of-the-art accounts for these novel kinds of intervention, indicates future developments, and discusses the relevant philosophical, ethical and legal issues.
Strategies or decisions aimed at affecting, in a manner considered to be positive, the genetic heritage of a child in the context of human reproduction are increasingly being accepted in contemporary society. As a result, unnerving similarities between earlier selection ideology so central to the discredited eugenic regimes of the 20th century and those now on offer suggest that a new era of eugenics has dawned. The time is ripe, therefore, for considering and evaluating from an ethical perspective both current and future selection practices. This inter-disciplinary volume blends research from embryology, genetics, philosophy, sociology, psychology, and history. In so doing, it constructs a thorough picture of the procedures emerging from today's reproductive developments, including a rigorous ethical argumentation concerning the possible advantages and risks related to the new eugenics.
For decades, the field of bioethics has shaped the way we think about ethical problems in science, technology, and medicine. But its traditional emphasis on individual interests such as doctor-patient relationships, informed consent, and personal autonomy is minimally helpful in confronting the social and political challenges posed by new human biotechnologies such as assisted reproduction, human genetic modification, and DNA forensics. Beyond Bioethics addresses these provocative issues from an emerging standpoint that is attentive to race, gender, class, disability, privacy, and notions of democracy-a "new biopolitics." This authoritative volume provides an overview for those grappling with the profound dilemmas posed by these developments. It brings together the work of cutting-edge thinkers from diverse fields of study and public engagement, all of them committed to this new perspective grounded in social justice and public interest values.
In Ancient Concepts of the Hippocratic, Lesley Dean-Jones and Ralph Rosen have gathered 19 international authorities in ancient medicine to identify commonalities among the treatises of the Hippocratic Corpus which led scholars of antiquity to group them under the single name of Hippocrates. Most recent scholarship has drawn attention to the divergences between individual treatises and groups of treatises, emphasizing the agonistic facet of the ancient medical profession. In contrast, in this volume contributors look to find points of agreement between the writings that go beyond claims of rationality. Topics considered include ontological claims about the discipline of medicine itself, the view of the patient as a perceiving unity, theories on the function of glands and the importance of regimen.
Biomedical Ethics Reviews * 1990 is the eighth volume in a series of texts designed to review and update the literature on issues of central importance in bioethics today. Two topics are discussed in the present volume: (1) Should the United States Adopt a National Health Insurance Plan? and (2) Are the NIH Guidelines Adequate for the Care and Protection of Laboratory Animals? Each topic constitutes a separate section in our text; introductory essays briefly summarize the contents of each section. Bioethics is, by its nature, interdisciplinary in character. Recog nizing this fact, the authors represented in the present volume have made every effort to minimize the use of technical jargon. At the same time, we believe the purpose of providing a review of the recent literature, as well as of advancing bioethical discussion, is admirably served by the pieces collected herein. We look forward to the next volume in our series, and very much hope the reader will also.
Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of 'fetal patient' against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of 'fetal patient' from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.
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 book provides a perspective on the concepts placebo and placebo effects, which has been missing so far: a detailed analysis of the history of the terms, their current use, suggested alternatives and the implications of the conceptual confusion. Everybody knows something about placebos and placebo effects. If, however, people are asked to define the concepts, the spectrum becomes wide. Does 'placebo' refer to an inert treatment or does it cover all elements of the patient-physician-interaction except for pharmacological or other physiological mechanisms? Furthermore, if, by definition, a placebo has no effect, what sense does it make to talk about a 'placebo effect'? Even in scientific literature the concepts 'placebo' and 'placebo effect' are used in many senses and often in a confusing way. While this book discusses many issues which keep puzzling physicians, it also covers the historical developments of the concepts of placebo and placebo effect as well as the conceptual confusion in the definitions. This book is intended for physicians, philosophers, psychologists and any other people interested in placebos, placebo effects and the physician-patient relationship.
Clinicians must practice medicine in conformity with regulatory requirements. That is the daily challenge, and those requirements have been founded on medical law. This book describes clinical law. A series of 62 brief commentaries are described, each setting out an important clinical legal case decided in an English court. The clinical relevance of the judgement is explained, together with how it should influence the care of the patient. Clinical readers are given skeleton guidance by their regulators, but almost no specific tuition as to how to apply it. This book sets out how clinical law has been applied in numerous cases, and thus provides guidance which is directly applicable to every clinician's practice in the United Kingdom. Although most court cases concentrate on the medical aspects of patients' care, the common currencies within clinical law touch on all clinical professions. Doctors, physiotherapists and others take consent every day; pharmacists must protect confidentiality; speech therapists consider the capacity of their patients; and nurses wrestle with discussions relating to whether their patients wish to be resuscitated The book is directed at members of the eight regulated clinical professions, the lawyers who deal with disputes, and all potential patients. About the Author Robert Wheeler, RCS MS LLB(Hons) LLM is a Consultant Neonatal and Paediatric Surgeon. He is the Associate Medical Director for the Department of Clinical Law, University Hospital of Southampton, Southampton Hampshire, England and Honorary Senior Lecturer, University of Southampton. https://www.uhs.nhs.uk/HealthProfessionals/Clinical-law-updates/Clinicallawupdates.aspx
Clinicians must practice medicine in conformity with regulatory requirements. That is the daily challenge, and those requirements have been founded on medical law. This book describes clinical law. A series of 62 brief commentaries are described, each setting out an important clinical legal case decided in an English court. The clinical relevance of the judgement is explained, together with how it should influence the care of the patient. Clinical readers are given skeleton guidance by their regulators, but almost no specific tuition as to how to apply it. This book sets out how clinical law has been applied in numerous cases, and thus provides guidance which is directly applicable to every clinician's practice in the United Kingdom. Although most court cases concentrate on the medical aspects of patients' care, the common currencies within clinical law touch on all clinical professions. Doctors, physiotherapists and others take consent every day; pharmacists must protect confidentiality; speech therapists consider the capacity of their patients; and nurses wrestle with discussions relating to whether their patients wish to be resuscitated The book is directed at members of the eight regulated clinical professions, the lawyers who deal with disputes, and all potential patients. About the Author Robert Wheeler, RCS MS LLB(Hons) LLM is a Consultant Neonatal and Paediatric Surgeon. He is the Associate Medical Director for the Department of Clinical Law, University Hospital of Southampton, Southampton Hampshire, England and Honorary Senior Lecturer, University of Southampton. https://www.uhs.nhs.uk/HealthProfessionals/Clinical-law-updates/Clinicallawupdates.aspx
Synthetic biology is a dynamic, young, ambitious, attractive, and heterogeneous scientific discipline. It is constantly developing and changing, which makes societal evaluation of this emerging new science a challenging task, prone to misunderstandings. Synthetic biology is difficult to capture, and confusion arises not only regarding which part of synthetic biology the discussion is about, but also with respect to the underlying concepts in use. This book offers a useful toolbox to approach this complex and fragmented field. It provides a biological access to the discussion using a 'layer' model that describes the connectivity of synthetic or semisynthetic organisms and cells to the realm of natural organisms derived by evolution.Instead of directly reviewing the field as a whole, firstly our book addresses the characteristic features of synthetic biology that are relevant to the societal discussion. Some of these features apply only to parts of synthetic biology, whereas others are relevant to synthetic biology as a whole. In the next step, these new features are evaluated with respect to the different areas of synthetic biology. Do we have the right words and categories to talk about these new features? In the third step, traditional concepts like "life" and "artificiality" are scrutinized with regard to their discriminatory power. This approach may help to differentiate the discussion on synthetic biology. Lastly our refined view is utilized for societal evaluation. We have investigated the public views and attitudes to synthetic biology. It also includes the analysis of ethical, risk and legal questions, posed by present and future practices of synthetic biology.This book contains the results of an interdisciplinary research project and presents the authors' main findings and recommendations. They are addressed to science, industry, politics and the general public interested in this upcoming field of biotechnology.
The Routledge Handbook of Neuroethics offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. Written by 61 key scholars and fresh voices, the Handbook's easy-to-follow chapters appear here for the first time in print and represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the Handbook's utility by providing readers with a contextual map for different approaches to issues and a guide to further avenues of interest. Chapter 11 of this book is freely available as a downloadable Open Access PDF under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://www.routledgehandbooks.com/doi/10.4324/9781315708652.ch11
Is the legal protection that is given to the expression of Abrahamic religious belief adequate or appropriate in the context of English medical law? This is the central question that is explored in this book, which develops a framework to support judges in the resolution of contentious cases that involve dissension between religious belief and medical law, developed from Alan Gewirth's Principle of Generic Consistency (PGC). This framework is applied to a number of medical law case studies: the principle of double effect, ritual male circumcision, female genital mutilation, Jehovah's Witnesses (adults and children) who refuse blood transfusions, and conscientious objection of healthcare professionals to abortion. The book also examines the legal and religious contexts in which these contentious cases are arbitrated. It demonstrates how human rights law and the proposed framework can provide a gauge to measure competing rights and apply legitimate limits to the expression of religious belief, where appropriate. The book concludes with a stance of principled pragmatism, which finds that some aspects of current legal protections in English medical law require amendment.
Published in 1998, this book is a collected volume of papers from the first conference of the European Network for Biomedical ethics. The main subject of this conference is the ethical assessment of IVF in view of its concrete application as an infertility treatment and the consideration of possible alternatives for use. Twenty years after the introduction and the establishment of this therapy a more concrete evaluation of its medical indications, social conditions and consequences, the psychological consequences for the women involved and the parent-child relationship becomes possible. The legal and ethical evaluation of the reproduction technology as regards for example the legal and moral status of supernumery embyos in cryo-conservation has also to be considered in a European perspective. The ethical evaluation concentrates today on the new evolution that IVF technology takes in relation to the extension of diagnostics possibilities due to genetic research. Little work has been done on the connection between IVF and genetic diagnostics and therapy, so the medical and ethical evaluation of the connecting lines are also included in the book.
Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V. Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V. Campbell, who was the founding editor of the internationally renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues from various disciplines, including law and various branches of healthcare. The diversity of topics and depth of contributors' insights reflect the breadth and impact of Campbell's philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell's emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell's work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead.
This book addresses well-known issues - the ethical, legal, and social implications of human genetics - but does so from an unusual perspective: the perspective of the scientific community itself. In distinction to what is common in the ELSI literature, the book also discusses bioethical method. A new kind of casuistry is developed on the basis of the empirical findings of cognitive semantics. It will be of interest to philosophers, bioethicists, geneticists, and policymakers.
Research holds a key to preventing and effectively treating mental disorders, including ADHD, depression, schizophrenia, and substance abuse. Yet even as research holds out promise, mental health researchers face numerous ethical challenges. Responsible for ensuring participants are able and willing to grant consent, researchers must also constantly protect privacy and confidentiality. But for so many situations, the appropriate decisions are not so clear. An individual with cognitive deficits may have difficulty understanding a research study and granting informed consent, but nevertheless wants to participate. Many studies gather private information about medical records or illegal behaviour that could lead to emotional, social, or legal harm if shared, yet state laws and institutional review boards may require researchers to breach confidentiality in specific situations. Moreover, mental health consumers and other vulnerable research participants are frequently familiar with historical cases of abuse of human subjects, and may be mistrustful of researchers or fear exploitation. At the same time, researchers are often frustrated when they feel that advocates or institutional review boards erect barriers to research, even while failing to enhance the ethical treatment of participants. Ethical research is rarely simply about avoiding bad activities, and more frequently about how to pursue good research when multiple values and commitments conflict. Ethics in Mental Health Research explores how ethical issues arise in mental health research, and offers guidance to researchers who seek to comply with regulations while conducting research that is at once ethical and scientifically credible. Case studies used throughout illustrate a variety of situations and effective problem-solving strategies. This book is essential reading for mental health researchers, IRB members, and research advocates.
Public Bioethics collects the most influential essays and articles of James F. Childress, a leading figure in the field of contemporary bioethics. These essays, including new, previously-unpublished material, cohere around the idea of 'public bioethics,' which concerns the analysis and assessment of public policies in biomedicine, health care, and public health. The volume is divided into four sections - The first examines the principle of respect for autonomy and paternalistic policies and practices. The second explores the tension between bioethics, public policy, and religious convictions, such as the right of health care providers to conscientiously refuse to provide treatment to certain patients. The third section looks at practices and policiies related to organ transplantation; Childress places particular focus on determining death, obtaining first-person consent for deceased organ donation, fairly allocating donated organs, and related issues in the distribution of scarce resources. The final section maps the broad terrain of public ethics; Childress propoposes a triage framework for the use of resources in public health crises, addresses public health interventions that potentially infringe civil liberties, and sheds light on John Stuart Mill's misunderstood legacy on public health ethics. Public Bioethics deftly explicates both contemporary bioethical issues and the processes involved in determining appropriate policies and publicly justifying collective recommendations, reflecting the author's vast experience serving on public bioethics committees, particularly at the national level in the United States. Providing a thorough account of the principles that govern issues within the healthcare system, this book will appeal to bioethicists, physicians, and public policy-makers.
Biotechnologies already on the horizon will enable us to be smarter, have better memories, be stronger and quicker, have more stamina, live longer, be more resistant to diseases, and enjoy richer emotional lives. To some of us, these prospects are heartening; to others, they are dreadful. In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement. These raise enduring questions about what it is to be human, about individuality, about our relationship to nature, and about what sort of society we should strive to have. Allen E. Buchanan urges that the debate about enhancement needs to be informed by a proper understanding of evolutionary biology, which has discredited the simplistic conceptions of human nature used by many opponents of enhancement. He argues that there are powerful reasons for us to embark on the enhancement enterprise, and no objections to enhancement that are sufficient to outweigh them.
Life sciences have huge controversial social implications. In doing experiments with animals, plants or humans the welfare of these living beings can be hampered; in communicating research results private and public interests can be harmed (patents!) or at least severely influenced; in being a member of a research group issues of human rights (such as discriminatory behaviour) can become prominent; individual and collective forms of responsibility because of controversial types of research can become urgent. Funding organizations can confront scientists and engineers with new ethical issues; the public at large or, as is the case with sustainability, future generations can challenge existing ways of doing research, and educating and teaching can confront scientists with new ethical issues. In this book, resulting from an expert workshop at Wageningen University and Research Centre, European and American experts discuss such topics and theories as the relationship between ethics, professional ethics and business ethics, the public responsibility of researchers and communicating, organizing, teaching and discussing ethical issues.
Now fully revised and updated, Bioethics: An Anthology, 3rd edition, contains a wealth of new material reflecting the latest developments. This definitive text brings together writings on an unparalleled range of key ethical issues, compellingly presented by internationally renowned scholars. * The latest edition of this definitive one-volume collection, now updated to reflect the latest developments in the field * Includes several new additions, including important historical readings and new contemporary material published since the release of the last edition in 2006 * Thematically organized around an unparalleled range of issues, including discussion of the moral status of embryos and fetuses, new genetics, neuroethics, life and death, resource allocation, organ donations, public health, AIDS, human and animal experimentation, genetic screening, and issues facing nurses * Subjects are clearly and captivatingly discussed by globally distinguished bioethicists * A detailed index allows the reader to find terms and topics not listed in the titles of the essays themselves
Debate regarding organ sales is largely innocent of the history of thought on the matter. This volume seeks to remedy this shortcoming. Positions for or against a market in human organs are nested within moral intuitions, ontological or political theoretical premises, or understandings of special moral concerns, such as permissible uses of the body, which have a long history of analysis. The essays compass the views of Plato, Aristotle, Aquinas, Locke, Kant, Hegel, Mill and Christianity, as well as particular methodological approaches, such as the phenomenology of the body, natural law theory, legal theory and libertarian critique of legal theory. These discussions cluster a number of conceptually independent philosophical concerns: (1) What is the appropriate understanding of the relationship between persons and their bodies? (2) What does it mean to own' an organ? (3) Do governments have moral authority to regulate how persons use their own body parts? (4) What are the costs and benefits of a market in human organs? Such questions are related by an urgent public health challenge: the considerable disparity between the number of patients who could significantly benefit from organ transplantation and the number of human organs available for transplantation. This volume explores the theoretical, normative, and historical foundations for alternative policies for procurement and transplantation of human organs.
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. |
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