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.

With implications that go to the core of what it means to be human, the issues raised by genetic manipulation–especially cloning–have sparked a passionate debate among governmental, religious, and scientific quarters, as well as the media and the general public. Keeping to the actual science rather than speculation is of the utmost importance for an enlightened approach to this weighty discussion.

In clear, lively prose, The Science and Ethics of Engineering the Human Germ Line: Mendel’s Maze provides an authoritative treatment of the principles of science and bioethics that bear upon such technologies as germ-line insertion and cloning. It offers a realistic assessment of possible applications, limitations, and new developments likely to arise in these areas.

Written by a top physician-investigator, this book progresses from the basics of building a living organism from inanimate parts through to recombinant DNA technology, assisted reproductive technologies, and gene transfer and germ-line engineering. Ethical considerations are woven into this material throughout, while a special section covers the intellectual role played by various social biases.

As genetic and reproductive technologies spread from the laboratory to the clinic–and society takes further notice–students and practitioners of biology and medicine, as well as the interested general reader, will find The Science and Ethics of Engineering the Human Germ Line: Mendel’s Maze to be an essential and accessible guide to these important subjects.

Food products with genetically modified (GM) ingredients are common, yet many consumers are unaware of this. When polled, consumers say that they want to know whether their food contains GM ingredients, just as many want to know whether their food is natural or organic. Informing consumers is a major motivation for labeling. Consumers who want GM-free products will pay a premium to support voluntary labeling. Labeling need not be mandatory. When polled, consumers say that they want to know whether their food contains GM ingredients, just as many want to know whether their food is natural or organic. Informing consumers is a major motivation for labeling. Why do consumers want to know about GM ingredients? GM foods are tested to ensure safety and have been on the market for more than a decade. Still, many consumers, including some with food allergies, want to be cautious. Also, GM crops may affect neighboring plants through pollen drift. Despite tests for environmental impact, some consumers may worry that GM crops will adversely effect the environment. The study of risk and its management raises questions not settled by the life sciences alone. This book surveys various labeling policies and the cases for them. It is the first comprehensive, interdisciplinary treatment of the debate about labeling genetically modified food. The contributors include philosophers, bioethicists, food and agricultural scientists, attorneys/legal scholars, and economists.

What will be the greatest moral challenge facing our society throughout this century? Are we ready to face it? Editors Charles W. Colson and Nigel M. de S. Cameron, along with a panel of expert contributors, make the case in this book that the greatest watershed debates of the twenty-first century concerning ethics and public policy will surround the issue of biotechnology. In twelve essays they address several of the legal and ethical challenges before us: embryo research, stem cell research, cloning, genetic engineering, gene therapy, pharmacogenomics, cybernetics, nanotechnology and, of course, abortion. Contributors include William L. Saunders, J. D., Family Research Council Christopher Hook, M.D., The Mayo Clinic Henk Jochemsen, Ph.D., Free University of Amsterdam David A. Prentice, Ph.D., Indiana State University Nathan A. Adams IV, Ph.D., J.D., Christian Legal Society David Stevens, M.D., Christian Medical Association Paige Comstock Cunningham, J. D., Americans United for Life C. Ben Mitchell, Ph.D., Trinity Evangelical Divinity School Richard Doerflinger, M.A., Secretariat for Pro-life, National Conference of Catholic Bishops Wesley J. Smith, J.D., International Task Force on Euthanasia and Assistend Suicide Leaders in their fields, these contributors point out the crucial role Christians can and should play in the public square. The well-informed and forward-looking perspectives they present will help us prepare for the challenges ahead.

Law, Palliative Care and Dying critically examines the role of the legal framework in shaping the boundaries of palliative care practice. The work underlines the importance of a distinct legal framework for specialist palliative care which can provide clarity for both the healthcare professional and the patient. It examines the legal and ethical justifications for specialist palliative care practices and, in doing so, it questions the legitimacy of the distinction between euthanasia and practices such as palliative sedation. Moreover, this work discusses the influence of a human rights discourse on palliative care and examines the contribution of autonomy, dignity, and the right to palliative care. This book includes detailed comparative research on several European jurisdictions. The jurisdictions illustrate varied approaches to palliative care regulation and promotion. In this manner, the role of professional guidelines and legislation are drawn out and common themes in the regulation of palliative care emerge.

Culture, Health, and Social Change is the first of three volumes on Aging conceived for the International Library of Ethics, Law, and the New Medicine. Leading scholars from a range of disciplines contest some of the predominant paradigms on aging, and critically assess modern trends in social health policy. How we approach and understand "aging" will have indelible effects on existing and future elder citizens. Acknowledging the cultural variances that exist in the human experience of aging is therefore of vital importance in order to respond to individual needs in a manner that is not paternalistic, discriminatory, or exclusionary.

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.

Calum MacKellar is Director of Research of the Scottish Council on Human Bioethics, Edinburgh, and Visiting Professor of Bioethics at St Mary's University College, London, UK.

Christopher Bechtel holds a degree in philosophy and is a Research Fellow with the Scottish Council on Human Bioethics, Edinburgh, UK.

This volume is the result of a conference sponsored by the Medical Alumni Association of the University of California, Davis and held in Sacramento, California, in January, 2000, The purpose of this conference was to examine the impact ofvarious health care structures on the ability of health care professionals to practice in an ethically acceptable manner. One of the ground assumptions made is that ethical practice in medicine and its related fields is difficult in a setting that pays only lip service to ethical principles. The limits of ethical possibility are created by the system within which health care professionals must practice. When, for example, ethical practice necessitates-as it generally does-that health care professionals spend sufficient time to come to know and understand their patients' goals and values but the system mandates that only a short time be spent with each patient, ethical practice is made virtually impossible. One of our chief frustrations in teaching health care ethics at medical colleges is that we essentially teach students to do something they are most likely to find impossible to do: that is, get to know and appreciate their patients' goals and values. There are other ways in which systems alter ethical possibilities. In a system in which patients have a different physician outside the hospital than they will inside, ethical problems have a different shape than if the treating physician is the same person.

Suffering is a central component of our lives. We suffer pain. We fall ill. We fail and are failed. Our loved ones die. It is a commonplace to think that suffering is, always and everywhere, bad. But might suffering also be good? If so, in what ways might suffering have positive, as well as negative, value? This important volume examines these questions and is the first comprehensive examination of suffering from a philosophical perspective. An outstanding roster of international contributors explore the nature of suffering, pain, and valence, as well as the value of suffering and the relationships between suffering, morality, and rationality. Philosophy of Suffering: Metaphysics, Value, and Normativity is essential reading for students and researchers in philosophy of mind, philosophy of psychology, cognitive and behavioral psychology as well as those in health and medicine researching conceptual issues regarding suffering and pain.

Western societies generally recognize both a legal and a moral right to privacy. However, at the present time there is no settled opin ion in the United States regarding how these rights should relate to medical information. On the one hand, virtually everyone agrees that one' s medical records should not be open to just any interested person' s inspection. On the other hand, most also agree that some sacrifices in medical privacy are necessary for scientific advancement, public health protection, and other social goals. However, what limits should be set upon those sacrifices, and how those limits should be determined, have long been issues of debate. In recent years this debate has intensified. There are a variety ofreasons for this; to mention only three: (1) Over the years the US health care delivery system has become increasingly complex, and with this complexity there has come a need for more and more people to have access to patients' medical records. With each transference of information, breaches in confidentiality become more likely. (2) Medical costs have risen at an alarming rate. This makes health insurance a virtual necessity for adequate medical care, and people worry that they will be denied employment and/or medical cov erage if certain sorts of medical information are not kept strictly confi dential. (3) Finally, many medical records are now kept in computer files, and the impossibility of guaranteeing confidentiality for files of this sort is a constant worry."

Patient organizations and social health movements offer one of the most important and illuminating examples of civil society engagement and participation in scientific research and research politics. Influencing the research agenda, and initiating, funding and accelerating the development of diagnostic tools, effective therapies and appropriate health-care for their area of interest, they may champion alternative, sometimes controversial, programs or critique dominant medical paradigms. Some movements and organizations advocate for medical recognition of contested illnesses, as with fibromyalgia orADHD, while some attempt to "de-medicalize" others, such as obesity or autism. Bringing together an international selection of leading scholars and representatives from patients' organizations, this comprehensive collection explores the interaction between civil society groups and biomedical science, technology development, and research politics. It takes stock of the key findings of the research conducted in the field over the past two decades and addresses emerging problems and future challenges concerning the interrelations between health movements and patient organisations on the one hand, and biomedical research and research policies on the other hand. Combining empirical case studies with conceptual discussion, the book discusses how public participation can contribute to, as well as restrict, the democratization of scientific knowledge production. This volume is an important reference for academics and researchers with an interest in the sociology of health and illness, science and technology studies, the sociology of knowledge, medical ethics or healthcare management and research, as well as medical researchers and those involved with health-related civil society organizations.

Medical therapy, research and technology enable us to make our bodies, or parts of them, available to others in an increasing number of ways. This is the case in organ, tissue, egg and sperm donation as well as in surrogate motherhood and clinical research. Bringing together leading scholars working on the ethical, social and cultural aspects of such bodily exchanges, this cutting-edge book develops new ways of understanding them. Bodily Exchanges, Bioethics and Border Crossing both probes the established giving and selling frameworks for conceptualising bodily exchanges in medicine, and seeks to develop and examine another, less familiar framework: that of sharing. A framework of sharing can capture practices that involve giving up and giving away part of one's body, such as organ and tissue donation, and practices that do not, such as surrogacy and research participation. Sharing also recognizes the multiple relationalities that these exchanges can involve and invites inquiry into the context in which they occur. In addition, the book explores the multiple forms of border crossing that bodily exchanges in medicine involve, from the physical boundaries of the body to relational borders - as can happen in surrogacy - to national borders and the range of ethical issues that these various border-crossings can give rise to. Engaging with anthropology, sociology, philosophy, and feminist and postcolonical perspectives, this is an original and timely contribution to contemporary bioethics in a time of increasing globalization. It will be of use to students and researchers from a range of humanities and social science backgrounds as well as medical and other healthcare professionals with an interest in bioethics.

This book,the second produced by the Cambridge Socio-Legal Group, is a collection of essays on the subject of law and the human body. As the title suggests, bodies and body parts are not only subject to regulation through formal legal processes, but also the meanings attached to particular bodies, and the significance accorded to some body parts, are aspects of broader cultural processes. In short, bodies are subjected to both lore and laws. The contributors, all leading academics in the fields of Law, Sociology, Psychology, Feminism, Criminology, Biology and Genetics, respectively, offer a range of interdisciplinary papers that critically examine how bodies are constructed and regulated in law. The book is divided into two parts. Part one is concerned with 'Making Bodies' and includes papers relating to transactions in human gametes, cloning, court-ordered caesarean sections, testing for genetic risk, the patenting of human genes and the social policy implications of the growth in genetic information. Part two is concerned with 'Using and Abusing Bodies'. It contains chapters relating to sexualities, sexual orientation and the law, sex workers and their clients, domestic homicide, religious and cultural practices and other issues involving children's bodies, the ownership of the body and body parts and the legal and ethical issues surrounding euthanasia.

This important work takes as its subject one of medicine 's most pressing arenas of ethical debate. There has been a consistent interest in ethical issues arising in the context of HIV research. Ongoing international and multi-site studies and the continuing search for an HIV vaccine continue to prompt examination of how this research is conducted. Also examined are how participants are engaged in the studies and the obligations of the researchers to individual participants and their communities during the course of and following the conclusion of the research. Each chapter of this book is authored primarily by one of the editors (secondarily by the other) and is accompanied by one to two case studies.

Partiality and Justice in Nursing Care examines the conflicting normative claims of partiality and impartiality in nursing care, looking in depth at how to reconcile reasonable concerns for one particular patient with equally important concerns for the maximisation of health-related welfare for all with relevant nursing-care needs, in a resource-limited setting. Drawing on moral philosophy, this book explores how discussions of partiality and impartiality in moral philosophy can have relevance to the professional context of clinical nursing care as well as in nursing ethics in general. It develops a framework for normative nursing ethics that incorporates a notion of permissible partiality, and specifies which concerns an ethics of nursing care should entail when balancing partialist and impartialist concerns. At the same time, Nordhaug argues that this partiality must also be constrained by both principled and context-sensitive assessments of patients' needs, as well as of the role-relative deontological restriction of minimising harm, something that could be mitigated by institutional and organisational arrangements. This thought-provoking volume is an important contribution to nursing ethics and philosophy.

The Elements of Ethical Dilemmas: Applied Psychology Ethics in Australia is a comprehensive and applied guide to practising psychology in an ethical and professional manner. This book is designed to assist applicants for general registration as a psychologist successfully navigate one of the eight core competencies for general registration set by the Psychology Board of Australia; specifically ethical, legal, and professional matters. The exploration of ethical dilemmas is a core task for the 4+2 pathway to general registration, while related ethical applications require exploration in the 5+1 and higher education pathways to registration as well. This book will teach readers how to identify, explore, and choose the appropriate professional course of action when confronted by ethical dilemmas in practice. The chapters include personal reflections from expert contributors relating to each of the ethical dilemmas, expertly highlighting clients' and stakeholders' circumstances, ethical codes and guidelines, scholarship and research, as well as other key elements in the ethical decision-making process. Especially relevant to those applying to become a registered psychologist in Australia, this book offers invaluable guidance on responding to ethical dilemmas as required by the Psychology Board of Australia in various pathways to general registration.

Dorothy Wertz and John Fletcher pioneered the first international study of ethical and social issues in genetics in 18 nations. This book reports and discusses their second and more representative study in 36 nations. The survey focused on actual situations that occur in the practice of medical genetics, presented as case vignettes that can also be used in teaching and policy discussion. Among the issues discussed are privacy, prenatal diagnosis, patient autonomy, directiveness in counseling, sex selection, forensic DNA banking, "genetic discrimination," and "eugenics."
This is Dorothy Wertz's final book, as she died in April, 2003. It is a one of a kind cross-cultural study of complex ethical issues in the uses of genetic information. No one else has attempted to look at the international aspects of medical genetics on such a broad scale. The results provide a resource for discussion both within and among nations. Much bioethical and policy discussion now occurs in an information vacuum. The survey showed that what people would do, and their reasons for doing it, differed considerably from what ethicists think they "should" do. Many will be surprised at the results, especially in nations where bioethical discussion is just beginning.
Genetics and Ethics in Global Perspective is of interest to medical geneticists, genetic counselors, social scientists and anthropologists who study cross-cultural issues, bioethicists and bioethics centers and health policy makers.

Biosecurity Dilemmas examines conflicting values and interests in the practice of "biosecurity," the safeguarding of populations against infectious diseases through security policies. Biosecurity encompasses both the natural occurrence of deadly disease outbreaks and the use of biological weapons. Christian Enemark focuses on six dreaded diseases that governments and international organizations give high priority for research, regulation, surveillance, and rapid response: pandemic influenza, drug-resistant tuberculosis, smallpox, Ebola, plague, and anthrax. The book is organized around four ethical dilemmas that arise when fear causes these diseases to be framed in terms of national or international security: protect or proliferate, secure or stifle, remedy or overkill, and attention or neglect. For instance, will prioritizing research into defending against a rare event such as a bioterrorist attack divert funds away from research into commonly occurring diseases? Or will securitizing a particular disease actually stifle research progress owing to security classification measures? Enemark provides a comprehensive analysis of the ethics of securitizing disease and explores ideas and policy recommendations about biological arms control, global health security, and public health ethics.

What role does ethics play in the practice of psychoanalysis and psychotherapy? For most of its history, psychoanalysis has viewed ethics as a "side issue" in clinical work-occasionally relevant, but not central to therapeutic action. In Psychoanalysis as an Ethical Process, Robert Drozek highlights the foundational importance of ethical experience in the therapeutic relationship, as well as the role that ethical commitments have played in inspiring what has been called the "relational turn" in psychoanalysis. Using vivid clinical examples from the treatment of patients with severe personality disorders, Drozek sketches out an ethically grounded vision of analytic process, wherein analyst and patient are engaged in the co-construction of an intersubjective space that is progressively more consistent with their intrinsic worth as human beings. Psychoanalysis can thus be seen as a unique vehicle for therapeutic and ethical change, leading to a dramatic expansion of agency, altruism, and self-esteem for both participants. By bringing our analytic theories into closer contact with our ethical experiences as human beings, we can connect more fully with the fundamental humanity that unites us with our patients, and that serves as the basis for deep and lasting therapeutic change. This book will be of interest to psychotherapists and psychoanalysts, as well as scholars in ethical theory and philosophy.

This title was first published in 2002: This volume discusses the subject of biomedical ethics. Various views, historical and contemporary, are discussed, with the editors using the contrasting concepts in the shift from paternalism to autonomy in 20th-century medicine as a heuristic tool for the critical study of ethics in medicine.As far as the evidence in this volume goes, paternalistic medical practices and patient autonomy had an uneasy relationship by the beginning of the 20th century. A hundred years later, full autonomy in decisions on medical treatment is still subject to numerous caveats. The text pays close attention to the interplay between various players, noting how factors such as social contexts, governmental organizations and the biotechnological industry influence and shape responses to the principle of bioethics.

The financial burden and the level of specialized care required to look after older adults with dementia has reached the point of a public health crisis. Older adults diagnosed and living with the disorder reached 35.6 million worldwide in 2010 and is expected to increase to 135.5 million in 2050, with costs soaring to $1.1 trillion. In the face of the increasing burden this disorder poses to health care systems and the management of this patient population, intelligent assistive technologies (IATs) represent a remarkable and promising strategy to meet the need of persons suffering from dementia. These technologies aim at helping individuals compensate for specific physical and cognitive deficits, and maintain a higher level of independence at home and in everyday activities. However, the rapid development and widespread implementation of these technologies are not without associated challenges at multiple levels. An international and multidisciplinary group of authors provide future-oriented and in-depth analysis of IATs. Part I delineates the current landscape of intelligent assistive technologies for dementia care and age-related disability from a global perspective, while the contributions in Part II analyze and address the major psycho-social implications linked to the development and clinical use of IATs. In the last section, essays examine the major ethical, social and regulatory issues associated with the use of IATs in dementia care. This volume provides an authoritative and comprehensive overview of how IATs are reshaping dementia care.

The Aging Self and the Aging Society Ethical issues involving the elderly have recently come to the fore. This should come as no surprise: Since the turn of the century, there has been an eightfold in crease in the number of Americans over the age of sixty five, and almost a tripling of their proportion to the general population. Those over the age of eighty-five- the fastest growing group in the country-are twenty one more times as numerous as in 1900. Demographers expect this trend to accelerate into the twenty-first century. The aging of society casts into vivid relief a num ber of deep and troubling questions. On the one hand, as individuals, we grapple with the immediate experience of aging and mortality and seek to find in it philosophical or ethical significance. We also wonder what responsi bilities we bear toward aging family members and what expectations of others our plans for old age can reasona bly include. On the other hand, as a community, we must decide: What special role, if any, do older persons occupy in our society? What constitutes a just distribution of medical resources between generations? And, How can institutions that serve the old foster imperiled values, such as autonomy, self-respect, and dignity? Only recently have we begun to explore these themes, yet already a rich and fruitful literature has grown up around them."

David M. Craig traveled across the United States to assess health care access, delivery and finance in this country. He interviewed religious hospital administrators and interfaith activists, learning how they balance the values of economic efficiency and community accountability. He met with conservatives, liberals, and moderates, reviewing their ideas for market reform or support for the Affordable Care Act. He discovered that health care in the US is not a private good or a public good. Decades of public policy and philanthropic service have made health care a shared social good.

"Health Care as a Social Good: Religious Values and the American Democracy" argues that as escalating health costs absorb more and more of family income and government budgets, we need to take stock of the full range of health care values to create a different and more affordable community-based health care system. Transformation of that system is a national priority but Americans have failed to find a way to work together that bypasses our differences. Craig insists that community engagement around the common religious conviction that healing is a shared responsibility can help us achieve this transformation -- one that will not only help us realize a new and better system, but one that reflects the ideals of American democracy and the common good.

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.

Critical Choices and Critical Care brings together the traditional reflections on ordinary and extraordinary means with Catholic social thought. It examines the difficult questions on the allocation of high technology resources used in intensive care medicine. The book also provides relevant background information (e.g. statements by the Society of Critical Care Medicine and the Congregation for the Doctrine of the Faith). It is accessible to theologians, philosophers, and health care professionals.