Ethics in Mental Health-Substance Use aims to explore the comprehensive concerns and dilemmas occurring from mental health and substance use problems, and to inform, develop, and educate by sharing and pooling knowledge, and enhancing expertise, in this fast developing region of ethics and ethical care and practice. This volume concentrates on ethical concerns, dilemmas, and concepts specifically interrelated, as a collation of problem(s) that directly or indirectly affect the life of the individual and family. Whilst presenting a balanced view of what is ethically best practice today, this title challenges concepts and stimulates debate, exploring all aspects of the development in treatment, intervention and care responses, and the adoption of research-led best practice.

Decisions to withdraw or withhold life-sustaining treatment are contentious, and offer difficult moral dilemmas to both medical practitioners and the judiciary. This issue is exacerbated when the patient is unable to exercise autonomy and is entirely dependent on the will of others. This book focuses on the legal and ethical complexities surrounding end of life decisions for critically impaired and extremely premature infants. Neera Bhatia explores decisions to withdraw or withhold life-sustaining treatment from critically impaired infants and addresses the controversial question, which lives are too expensive to treat? Bringing to bear such key issues as clinical guidance, public awareness, and resource allocation, the book provides a rational approach to end of life decision making, where decisions to withdraw or withhold treatment may trump other competing interests. The book will be of great interest and use to scholars and students of bioethics, medical law, and medical practitioners.

This volume introduces a new subseries of Philosophy and Medicine, Classics of Medical Ethics. The purpose of this new subseries is to bring out scholars' editions of major works in the history of medical ethics and philosophy of medicine. This new subseries will target for publication texts that are long out of print and difficult to access. Each volume will contain an introduction to the writings on medical ethics and philosophy of medicine produced by the original author. Each volume will also contain a guide to the primary and major secondary Hterature, to facilitate teaching and scholarship in bioethics, philosophy of medicine, and history of medicine. Texts will be presented in their origi nal style and will provide pagination of the original, so that citations can be made either to the original text or to the page numbers in these vol umes. Finally, each volume will be well indexed, again to facilitate teaching and research. Bioethics and philosophy of medicine - the former more so than the latter - have an insufficiently developed understanding of themselves as having a history. As a consequence, these fields lack the maturity that critical dialogue of the past with the present provides for other fields and disciplines of the humanities. To the extent that this problem is due to the fact that major primary historical sources are not readily available, this subseries will contribute to the further development and maturation of bioethics and philosophy of medicine as fields of the humanities."

Through the sobering story of Maggie Worthen and her mother, Nancy, this book tells of one family's struggle with severe brain injury and how developments in neuroscience call for a reconsideration of what society owes patients at the edge of consciousness. Drawing upon over fifty in-depth family interviews, the history of severe brain injury from Quinlan to Schiavo, and his participation in landmark clinical trials, such as the first use of deep brain stimulation in the minimally conscious state, Joseph J. Fins captures the paradox of medical and societal neglect even as advances in neuroscience suggest new ways to mend the broken brain. Responding to the dire care provided to these marginalized patients, after heroically being saved, Fins places society's obligations to patients with severe injury within the historical legacy of the civil and disability rights movements, offering a stirring synthesis of public policy and physician advocacy.

This book gives an overview of the potential and the practical details that need to be resolved in order to make human germline engineering possible. It presents the ethical and social concerns, and implications of our fast-approaching capability to alter our own germline and take an active role in the future evolution of our own species. It provides explanations of how we have arrived at the capability to clone higher animals, and discusses the implications for human therapies and for our own future when these techniques are applied to the human germline.

Not long ago, a colleague chided me for using the term "the biological revolution. " Like many others, I have employed it as an umbrella term to refer to the seemingly vast, rapidly-moving, and fre quently bewildering developments of contemporary biomedicine: psy chosurgery, genetic counseling and engineering, artificial heart-lung machines, organ transplants-and on and on. The real "biological revo lution," he pointed out, began back in the nineteenth century in Europe. For it was then that death rates and infant mortality began to decline, the germ theory of disease was firmly established, Darwin took his famous trip on the Beagle, and Gregor Mendel stumbled on to some fundamental principles of heredity. My friend, I think, was both right and wrong. The biological revolution did have its roots in the nineteenth century; that is when it first began to unfold. Yet, like many intellectual and scientific upheav als, its force was not felt for decades. Indeed, it seems fair to say that it was not until after the Second World War that the full force of the earlier discoveries in biology and medicine began to have a major impact, an impact that was all the more heightened by the rapid bi omedical developments after the war."

Who should have access to assisted reproductive technologies? Which one of many seriously ill patients should be offered the next available transplant organ? When may a surrogate decision maker decide to withdraw life-prolonging measures from an unconscious patient? Questions like these feature prominently in the field of health care ethics and in the education of health care professionals. This book provides a concise introduction to the major concepts, principles and issues in health care ethics, using case studies throughout to illustrate and analyse challenging ethical issues in contemporary health care. Topics range widely, from confidentiality and truthfulness to end-of-life care and research on human subjects. Ethics and Health Care will be a vital resource for students of applied ethics, bioethics, professional ethics, health law and medical sociology, as well as students of medicine, nursing and other health care professions.

BOOK OF THE YEAR IN THE SPECTATOR AND THE TIMES 'Fascinating.... Deeply disturbing... Brilliant' Sunday Times 'Powerful and moving.' Louis Theroux Meet Adam. He's twenty-seven years old, articulate and attractive. He also wants to die. Should he be helped? And by whom? In The Inevitable, award-winning journalist Katie Engelhart explores one of our most abiding taboos: assisted dying. From Avril, the 80-year-old British woman illegally importing pentobarbital, to the Australian doctor dispensing suicide manuals online, Engelhart travels the world to hear the stories of those on the quest for a 'good death'. At once intensely troubling and profoundly moving, The Inevitable interrogates our most uncomfortable moral questions. Should a young woman facing imminent paralysis be allowed to end her life with a doctor's help? Should we be free to die painlessly before dementia takes our mind? Or to choose death over old age? A deeply reported portrait of everyday people struggling to make impossible decisions, The Inevitable sheds crucial light on what it means to flourish, live and die.

Population genomics research drawing on genetic databases has expanded rapidly, with some of this information being combined in 'biobanks'. Managing this information in an appropriate way is a highly complex ethical issue in the health policy arena. This book combines theoretical and empirical research to analyze the areas of conflict and consensus in the regulatory and ethical frameworks that have been developed to govern biobanks. Ethicists from the Department of Ethics, Trade, Human Rights and Health Law (ETH) of the World Health Organization, the Institute of Biomedical Ethics of Geneva University and the Institute of Biomedical Ethics of the University of Zurich, with the support of the Geneva International Academic Network (GIAN), examine the conditions under which genetic databases can be established, kept, and made use of in an ethically acceptable way. In addition to a comprehensive review of the scientific literature and a comparative analysis of existing normative frameworks, they present the results of in-depth interviews with experts around the world concerning the most unresolved and controversial issues. The results of that study, combined with their normative analysis, leads to recommendations for a better international framework.

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.

Set against a backdrop of cultural diversity, the current emphasis on advance care planning, both in the United States and abroad, necessitates a sourcebook on how to navigate such complex terrain. This book will serve as a guide to best practice for advance care planning in a multicultural society. Such a guide will help those trying to engage in the often delicate discussions that take place during advance care planning to do so in a culturally sensitive manner. In addition, the book will provide general guidance in discussing difficult issues in a multicultural clinical setting. Given how entrenched advance care planning is in the medical context, to not attempt to engage in the process in a culturally sensitive way smacks of a dangerous indifference and sets the stage for conflict where calm could exist. In the fast-paced world of clinical medicine, recognizing and acknowledging differences in worldviews is often overlooked. When dealing with the delicate issues broached in advance care planning, such oversights can lead to deep rifts within the health care provider-patient relationship. This damage can be irreparable. By providing guidance to those engaged in such endeavors and setting advance care planning in a global context, health care practitioners will be better able to care for their patients and achieve the noble goal of advance care planning_giving volume to the voice of the patient in the last chapter of her life.

Res Ipsa Loquitur and Medical Negligence: A Comparative Survey analyses the application of the doctrine of res ipsa loquitur ('it speaks for itself') to medical negligence cases. The book aims to establish conclusively that the approach of the South African courts, that the doctrine should never find application in medical negligence cases, is untenable and out of touch with modern approaches adopted in other countries. Constitutional principles such as procedural equality, access to courts, access to health care, access to information, post-constitutional legislation, medical ethics and policy considerations are also discussed.

The book further provides a theoretical and practical legal framework for the application of the doctrine to medical negligence cases in South Africa in future. The authors argue for the application of the doctrine, not only in medical negligence cases, but also to related legal procedures that follow a medical accident such as medical inquests, criminal prosecutions and disciplinary inquiries instituted by the Health Professions Council of South Africa.

Res Ipsa Loquitur and Medical Negligence includes a comprehensive comparison of the practical application of the doctrine to medical negligence cases in South Africa, England and the United States of America.

This volume reviews the state of the art in caring for patients dying in the ICU, focusing on both clinical aspects of managing pain and other symptoms, as well as ethical and societal issues that affect the standards of care recieved, The book also addresses the changing epidemiology of death in this setting related to managed care, practical skills needed to provide the highest quality of care to terminal patients, communicating with patients and families, the mechanics of withdrawing life supporting therapies, and the essential role of palliative care specialists in the ICU. The book briefly describes unique issues that arise when caring for patients with some of the more common diseases that preciptate death in the ICU. Contributors for the book were chosed because they have experience caring for patients in the ICU, and are also doing curent research to find ways to improve care for terminal patients in this setting.

Public health is an important and fast-developing area of ethical discussion. In this volume a range of issues in public health ethics are explored using the resources of moral theory, political philosophy, philosophy of science, applied ethics, law, and economics. The twelve original papers presented consider numerous ethical issues arise within public health ethics. To what extent can the public good or the public interest justify state interventions that impose limits upon the freedom of individuals? What role should the law play in regulating risks? Should governments actively aim to change our preferences about such things as food, smoking or physical exercise? What are public goods, and what role (if any) do they play in public health? To what extent do individuals have moral obligations to contribute to protecting the community or the public good? Where is it appropriate to concentrate upon prevention rather than cure? Given the fact that we cannot be protected from all harm, what sorts of harm provide a justification for public health action? What limits do we wish to place upon public health activities? How do we ensure that the interests of individuals are not set aside or forgotten in the pursuit of population benefits? An excellent line-up of authors from North America, Europe, and the UK tackle these questions.

Person-centred health care is increasingly endorsed as a key element of high-quality care, yet, in practice, it often means patient-centred health care. This book scrutinizes the principle of primacy of patient welfare, which, although deeply embedded in health professionalism, is long overdue for critical analysis and debate. It appears incontestable because patients have greater immediate health needs than clinicians and the patient-clinician encounter is often recognized as a moral enterprise as well as a service contract. However, Buetow argues that the implication that clinician welfare is secondary can harm clinicians, patients and health system performance. Revaluing participants in health care as moral equals, this book advocates an ethic of virtue to respect the clinician as a whole person whose self-care and care from patients can benefit both parties, because their moral interests intertwine and warrant equal consideration. It then considers how to move from values including moral equality in health care to practice for people in their particular situations. Developing a genuinely inclusive concept of person-centred care - accepting clinicians as moral equals - it also facilitates the coalescence of patient-centred care and evidence-based health care. This reflective and provocative work develops a constructive alternative to the taken-for-granted principle of primacy of patient welfare. It is of interest to students and academics in the health and caring sciences, philosophy, ethics, medical humanities and health management.

Updated, reorganized, and streamlined to focus squarely on ethical decision making in counseling and psychotherapy and in the practice of specialties in counseling. The fifth edition of this text is unparalleled in helping counselors-in-training use ethical decision-making processes as a foundation for approaching ethical and legal dilemmas in clinical practice. Newly organized and streamlined to eliminate redundancies, this textbook presents multiple new chapters that reflect the latest developments in counseling specialty areas. This new edition also features an overview of ethical decision-making models, principles, and standards. Abundant instructor resources, reflecting changes to the fifth edition, include an Instructor's Manual, Power Points, Sample Syllabi, and a Test Bank. Through its alignment with the CAPREP standards, the new edition continues to deliver a comprehensive overview of ethical decision-making models in each chapter, along with step-by-step processes for applying these models to a wide range of clinical cases. Case scenarios specific to specialized practice issues provide insight into practice with different client populations. Additionally, the text considers office, administrative, electronic, technology, and related issues, and the role of values in counseling addressing contemporary emphasis on ethical treatment of value conflicts that are crucial to the operation of all practices. Abundant features highlight key content and reinforce learning, including bold-faced key terms with definitions, boxed content showcasing crucial information, and reflection questions to stimulate rigorous thinking. Purchase includes digital access for use on most mobile devices or computers. New to the Fifth Edition: Reorganized and streamlined for ease of use Includes updated reference to codes of ethics from ASCA and AMHCA Addresses shifts in the structure of specialty practices including the merger of CORE and CACREP Provides several new chapters on clinical specialties and supervision issues Focuses on ethics in counseling specialties: clinical mental health; school; couples, marriage and family; addictions; career; rehabilitation; and group Addresses ethical practice of the new clinical rehabilitation counseling specialty-the only text to do so Offers student learning activities in each chapter with additional practice scenarios available for downloading Provides access to appropriate codes of ethics via chapter-by-chapter links Delivers updated case scenarios Key Features: Covers all counseling specialties and their respective ethical codes aligning with recent developments in the profession Describes how to avoid, address, and solve serious ethical and legal dilemmas to prepare counselors-in-training for complex situations they may encounter Includes objectives, case studies, references, key terms, learning activities and reflection questions embedded in chapter content Highlights important information with boxed callouts Addresses key office, administrative, electronic, technology, and other practice issues Provides Appendix with web links to codes of ethics in counseling and specialties Includes Dr. Cottone's Social Constructivism Decision-Making Model and Dr. Tarvydas's Integrative Decision-Making Model

Law, Immunization and the Right to Die focuses on the urgent matter of legal appeals and judicial decisions on assisted death. Drawing on key cases from the United Kingdom and Canada, the book focuses on the problematic paternalism of legal decisions that currently deny assisted dying and questions why the law fails to recognize what many describe as "compassionate motives" for assisted death. When cases are analyzed as discourses that are part of a larger socio-political logic of governance, judicial decisions, it is argued here, reveal themselves as relying on the construction of neoliberal fictions - fictions that are here elucidated with reference to Michel Foucault's theoretical insights on pastoral power and Roberto Esposito's philosophical thesis on immunization. Challenging the socio-political logic of neoliberalism, the issue of assisted dying goes beyond the predominant legal concern with protecting - or immunizing - individuals from one another, in favor of minimal interference. This book calls for a new kind of politics: one that might affirm people and their finitude both more collectively, and more compassionately.

Informed consent - as an ethical ideal and legal doctrine - has been the source of much concern to clinicians. Drawing on a diverse set of backgrounds and two decades of research in clinical settings, the authors - a lawyer, a physician, a social scientist, and a philosopher - help clinicians understand and cope with their legal obligations and show how the proper handling of informed consent can improve , rather than impede, patient care. Following a concise review of the ethical and legal foundations of informed consent, they provide detailed, practical suggestions for incorporating informed consent into clinical practice. This completely revised and updated edition discusses how to handle informed consent in all phases of the updated edition discusses how to handle informed consent in all phases of the doctor-patient relationship, use of consent forms, patients' refusals of treatment, and consent to research. It comments on recent laws and national policy, and addresses cutting edge issues such as fulfilling physician obligations under managed care. This clear and succinct book contains a weath of information that will not only help clinicians meet the legal requirements of informed consent and understand its ethical underpinnings, but also enhance their ability to deal with their patients more effectively. It will be of value to all those working in areas where issues of informed consent are likely to arise, including medicine, biomedical research, mental health care, nursing, dentistry, biomedical ethics, and law.

The Law and Ethics of Medicine: Essays on the Inviolability of Human Life explains the principle of the inviolability of human life and its continuing relevance to English law governing aspects of medical practice at the beginning and end of life. The book shows that the principle, though widely recognized as an historic and foundational principle of the common law, has been misunderstood in the legal academy, at the Bar and on the Bench. Part I of the book identifies the confusion and clarifies the principle, distinguishing it from 'vitalism' on the one hand and a 'qualitative' evaluation of human life on the other. Part II addresses legal aspects of the beginning of life, including the history of the law against abortion and its relevance to the ongoing abortion debate in the US; the law relating to the 'morning after' pill; and the legal status of the human embryo in vitro. Part III addresses legal aspects of the end of life, including the euthanasia debate; the withdrawal of tube-feeding from patients in a 'persistent vegetative state'; and the duty to provide palliative treatment. This unique collection of essays offers a much-needed clarification of a cardinal legal and ethical principle and should be of interest to lawyers, bioethicists, and healthcare professionals (whether they subscribe to the principle or not) in all common law jurisdictions and beyond.

This book constructs a virtue-based ethics for medicine and health care. Beginning with the problem of relating virtues to principles, the authors develop a theory that this linkage lies in the goals of medicine and the nature of medical practice as a moral community. Specific virtues such as trust, compassion, prudence, justice, courage, temperance, and self-effacement are discussed in separate chapters. The book ends by examining how a virtue-based ethic of medicine makes a difference in analysing problems like caring for the poor, research on human subjects, whether the medical virtues can be taught in professional training, and how a refurbished philosophy of medicine can enhance medicine and health care in the future.

Death, violent or otherwise, is a matter of widespread concern with ongoing debates about such matters as euthanasia and the nature of brain death. Philosophers have often argued about the rationality of fear of death. This book argues that that dispute has been misconceived: fear of death is not something that follows or fails to follow from reason, but rather, it forms the basis of reasoning and helps to show why people must be cooperating beings who accept certain sorts of facts as reasons for acting. Within the context of this account of reasons, the book gives a new understanding of brain death and of physician-assisted suicide.

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.

Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths - e.g. 'vaccines cause autism' - have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-reliance systematically distorts beliefs in areas of inquiry in which expertise is required (like vaccine immunology). Second, vaccine refusers and mainstream medical authorities are often committed to different values surrounding health and safety. For example, while vaccine advocates stress that vaccines have low rates of serious complications, vaccine refusers often resist vaccination because it is 'unnatural' and because they view vaccine-preventable diseases as a 'natural' part of childhood. Finally, parents who refuse vaccines rightly resist the utilitarian moral arguments - 'for the greater good' - that vaccine advocates sometimes make. Unfortunately, vaccine refusers also sometimes embrace a pernicious hyper-individualism that sanctions free-riding on herd immunity and that cultivates indifference to the interpersonal and social harms that unvaccinated persons may cause.

First published in 1985. Routledge is an imprint of Taylor & Francis, an informa company.

The ethics of sports medicine is an important emerging area within biomedical ethics. The professionalization of medical support services in sport and continuing debates around issues such as performance-enhancing technologies or the health and welfare of athletes mean that all practitioners in sport, as well as researchers with an interest in sports ethics, need to develop a clear understanding of the ethical aspects of the sport-medicine nexus. This timely collection of articles explores the conceptual and practical issues that shape and define ethics in sports medicine. Examining central topics such as consent, confidentiality, pain, doping and genetic technology, this book establishes an important baseline for future academic and professional work in this area.