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Books > Medicine > General issues > Medical ethics
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."
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."
The majority of doctors and nurses involved in specialist palliative care reject the legalisation of physician assisted suicide (PAS). This book explores the reasons why the healthcare professionals who have the most experience of caring for dying patients should object to a change in the law. Debate about euthanasia and PAS often arises in response to a well publicised tragic case of unrelieved suffering. Such heart rending stories do not reflect the fact that the majority of people dying have a dignified death. There is a marked disparity between medical intuitions and the philosophers' arguments about euthanasia and PAS. It seems that part of the moral constitution of a doctor is a commitment not to intend the death of a patient and to protect them from harm. The perspective of those who are privileged to care for thousands of dying patients and their families should inform the debate about PAS.This book will enable those who are not working within palliative care to gain an insight into the scope of this speciality and to understand why legalisation of PAS should be resisted to maintain and improve care of dying patients.
The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging issues such as climate change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation.
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.
This book will be of tremendous use to all healthcare professionals from physicians to nurses to social workers, rehabilitation therapists, and chaplains. The pathway taken here is a sensible and reasonable one, emphasizing a patient-centred approach that underscores the importance of spiritually competent care. The Editors do an excellent job of describing how to integrate spirituality into patient care for all of the different healthcare professionals. They also emphasize the importance of an evidence-based approach that is guided by research. This book provides superb guidelines that will be enormously helpful to every healthcare professional. Harold G Koenig, M.D., Professor of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina This practical guide tackles the important issues of spirituality in health care, emphasising the role of organisations in developing a culture of leadership and management that facilitates spiritual care. Spirituality is a central part of holistic care that addresses physical, mental, emotional and spiritual aspects of care in an integrated way. The chapters are written by experts in their fields, pitched at the practitioner level rather than addressing 'spirituality' as a purely theoretical concept. Each one describes the realities of spiritually competent practice and show how it can be taught and put into practice in a variety of areas and settings, including Undergraduate and Postgraduate education Acute healthcare settings Mental health Primary care End of Life Care Creative organisations Social services Ideal for practitioners, educators, trainees and managers in nursing and healthcare, the book is also relevant reading for occupational therapists, physiotherapists, social workers and psychologists.
Simona Giordano presents the first full philosophical study of ethical issues in the treatment of anorexia and bulimia nervosa. Beginning with a comprehensive analysis of these conditions and an exploration of their complex causes, she then proceeds to address legal and ethical dilemmas such as a patient's refusal of life-saving treatment. Illustrated with many case-studies, Understanding Eating Disorders is an essential tool for anyone working with sufferers of these much misunderstood conditions, and for all those ethicists, lawyers, and medical practitioners engaged with the widely relevant issues they raise.
Our understanding of gender carries significant bioethical implications. An errant account of gender-specific disease can lead to overgeneralizations, undergeneralizations, and misdiagnoses. It can also lead to problems in the structure of health-care delivery, the creation of policy, and the development of clinical curricula. In this volume, Cutter argues that gender-specific disease and related bioethical discourses are philosophically integrative. Gender-specific disease is integrative because the descriptive roles of gender, disease, and their relation are inextricably tied to their prescriptive roles within frames of reference. An integrative account of gender-specific disease carries ethical implications because our understanding of gender-specific disease is evaluative, and our evaluations of gender-specific disease entail judgments concerning the praiseworthiness and blameworthiness of a clinical event. Cutter supports a "both/and" emphasis on context and integration in relation to gender-specific disease and bioethical analyses. While the text mainly focuses on gender-specific diseases that affect women, Cutter also includes examples involving men, children, and members of the LGBT community.
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.
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.
Environmental health encompasses the assessment and control of those environmental factors that can potentially affect human health, such as radiation, toxic chemicals and other hazardous agents. It is often assumed that the assessment part is just a matter of scientific research, and the control part a matter of implementing standards which unambiguously follow from that research. But it is less commonly understood that environmental health also requires addressing questions of an ethical nature. How can we determine the "acceptable" risk level for the general population or for certain groups? How should we deal with uneven distributions of risks and benefits? How do we communicate about risks with the stakeholders? This multidisciplinary collection brings together a number of leading researchers and scholars in order to generate discussion surrounding these key questions, and to bring the ethical implications of science and technology to the forefront of critical thought. Providing a broad overview of the Ethics of Environmental Health, its philosophical foundations and practical applications, this book offers a significant contribution to ongoing discussions in sustainable development and will be of interest to scholars and practitioners of Environmental Health, urban studies and healthcare.
Recent scientific developments, in particular advances in pharmacogenetics and molecular genetics, have given rise to numerous predictive procedures for detecting predispositions to diseases in patients. This knowledge, however, does not necessarily promise benign results for either patients or health care professionals. The aim of this volume is to analyse issues related to prediction and prognosis as a burgeoning field of medicine, which is revolutionizing the way we understand and approach diagnosis and treatment. Combining epistemic and ethical reflection with medical expertise on contemporary practice and research, an interdisciplinary group of international experts critically examine anticipatory medicine from various perspectives, including history of medicine, bioethics, theories of science, and health economics. The highly complex issues involved in medical prediction call for a far-reaching debate on the value and scope of foreknowledge. For example, which responsibilities and burdens arise when still healthy people learn of their predisposition to diseases? How should health care insurance reflect risky life styles? Is the increasing medicalization of life connected with prevention ethically sustainable and financially possible in the developing world? These and other related issues are the subject of this timely and important book, which not only serves as an introduction to the area, but also proposes many feasible solutions to the problems outlined.
The advancement of the life sciences and the technosciences has enhanced the longevity of citizens in the Western world, and half of the generation born in the first decade of the new millennium is now expected to live to the age of one hundred years. In a society with such longevity and affluence, consumption of health-related goods and services such as pharmaceuticals and scanning procedures may be seen as a sustainable source of income for the industries that promote it. Though the healthcare sector has traditionally been organized in the public sector in Europe and in the private sector in the US, the recent advancement of new therapies and direct-to-consumer marketing have opened up new streams of consumption and revenue for health care goods and services around the globe. This book examines the so-called 'bioeconomy' as a new economic and commercial field that emphasizes the management of individual life, including the regulation and control of weight and food consumption and other issues pertaining to individual well-being. In addition, the bioeconomy includes a variety of practices based on commercial interests such as organ donations, reproductive medicine and technologies, and what has been referred to as the tissue economy - the various forms of trade with human tissues. Author Alexander Styhre provides a thorough introduction to the bioeconomy, exploring this new and unique intersection of the life sciences and the technosciences with more traditional consumer markets.
In Suffering Narratives of Older Adults, Mary Beth Quaranta Morrissey turns to the traditions of phenomenology, humanistic psychology and social work to provide an in-depth exploration of the deep structure of the suffering experience. She draws upon the notion of maternal holding to develop an original construct of maternal affordances - the ground of possibility for human development, agency and relational practices. The conceptual analysis is based on the life narratives of several elders receiving chronic care in facility environments. Creating new fields of communication for patients, their family members and health professionals in processes of reflection and shared decision making, this book builds on knowledge about suffering to help guide ethical action in preventing and relieving chronic pain and improving systems of care. It offers a phenomenological approach to understanding the maternal as a primary domain of moral experience in serious illness and suffering, and implications for policy, practice and research. A series of applied chapters, looking at individual experiences of suffering and care experiences, present critical areas of ethical inquiry, including: pain and suffering maternal relational ethics evaluation and moral deliberation about care options decision-making and moral agency end-of-life experiences of care. Exploring how an ecological relational perspective grounded in phenomenology may provide fruitful alternatives to traditional frameworks in bioethics, this is an important contribution to the ongoing development of an ecological ethic of care. It will be of interest to scholars and students of bioethics and phenomenological methods in the health and human services, as well as practitioners in the field.
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.
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.
What is 'legal' about bioethics? What are the ideas and artefacts that bioethics encompasses, and how are they related to law? What is the role of law in bioethics? In this work, Calvin Ho attempts to address these questions in the context of the governance of human pluripotent stem cell research. In essence, he argues that the hybridization of law, through processes, devices and techniques of juridification, has helped to constitute bioethics as a public sphere and an emergent civic epistemology.Drawing on his multi-sited ethnographic fieldwork and on Actor-Network-Theory, Ho explains how the law has, through bioethics, contributed to the scientific and public understanding of human pluripotent stem cell research and its artefacts, particularly the embryo and human-animal combinations. Although the focus of his work is on bioethical developments in Singapore over a period of more than 15 years, parallel developments in key jurisdictions (especially the United States of America and the United Kingdom) and in international science policy are also evaluated. It is through appreciating how it has progressed that bioethics will be better able to engage with future challenges presented by advances in human embryo research and gene editing techniques, among others.
What is 'legal' about bioethics? What are the ideas and artefacts that bioethics encompasses, and how are they related to law? What is the role of law in bioethics? In this work, Calvin Ho attempts to address these questions in the context of the governance of human pluripotent stem cell research. In essence, he argues that the hybridization of law, through processes, devices and techniques of juridification, has helped to constitute bioethics as a public sphere and an emergent civic epistemology.Drawing on his multi-sited ethnographic fieldwork and on Actor-Network-Theory, Ho explains how the law has, through bioethics, contributed to the scientific and public understanding of human pluripotent stem cell research and its artefacts, particularly the embryo and human-animal combinations. Although the focus of his work is on bioethical developments in Singapore over a period of more than 15 years, parallel developments in key jurisdictions (especially the United States of America and the United Kingdom) and in international science policy are also evaluated. It is through appreciating how it has progressed that bioethics will be better able to engage with future challenges presented by advances in human embryo research and gene editing techniques, among others.
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.
Islamic Perspectives on the Principles of Biomedical Ethics presents results from a pioneering seminar in 2013 between Muslim religious scholars, biomedical scientists, and Western bioethicists at the research Center for Islamic Legislation & Ethics, Qatar Faculty of Islamic Studies. By examining principle-based bioethics, the contributors to this volume addressed a number of key issues related to the future of the field. Discussion is based around the role of religion in bioethical reasoning, specifically from an Islamic perspective. Also considered is a presentation of the concept of universal principles for bioethics, with a response looking at the possibility (or not) of involving religion. Finally, there is in-depth analysis of how far specific disciplines within the Islamic tradition - such as the higher objectives of Sharia (maqasid al-Shari'ah) and legal maxims (qawa'id fiqhiyah) - can enrich principle-based bioethics.
New technologies and medical treatments have complicated questions such as how to determine the moment when someone has died. The result is a failure to establish consensus on the definition of death and the criteria by which the moment of death is determined. This creates confusion and disagreement not only among medical, legal, and insurance professionals but also within families faced with difficult decisions concerning their loved ones. Distinguished bioethicists Robert M. Veatch and Lainie F. Ross argue that the definition of death is not a scientific question but a social one rooted in religious, philosophical, or social beliefs. Drawing on history and recent court cases, the authors detail three potential definitions of death--the whole-brain concept; the circulatory, or somatic, concept; and the higher-brain concept. Because no one definition of death commands majority support, it creates a major public policy problem. The authors cede that society needs a default definition to proceed in certain cases, like those involving organ transplantation. But they also argue the decision-making process must give individuals the space to choose among plausible definitions of death according to personal beliefs. Taken in part from the authors' latest edition of their groundbreaking work on transplantation ethics, Defining Death is an indispensable guide for professionals in medicine, law, insurance, public policy, theology, and philosophy as well as lay people trying to decide when they want to be treated as dead.
This book covers the new field of healthcare organization ethics from theory to practical application. It can be used as a text for courses on the subject, as a reference for those interested in the present status of the field, and as a practical guide for healthcare executives, clinicians and committee members who are beginning to develop an organizational ethics program for their institution.
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.
This book offers a unique description of how phenomenology can help professionals from medical, environmental and social fields to explore notions such as interaffectivity, empathy, epoche, reduction, and intersubjective encounter. Written by a group of top scholars, it uniquely covers the relationship between phenomenology and bioethics, and focuses not only on medical cases, but also on the environment and emerging technologies. This variety of themes, whilst including techno-ethics, environmental ethics, animal ethics, and medical ethics, is conducive to appreciating broadly how phenomenology can improve our quality of our life. Despite its difficult themes, the book appeals to an audience of both academics and professionals who are willing to understand how to increase the quality of care in their professional field. Chapter 8 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
For more than twenty years Practical Decision Making in Health Care Ethics has offered scholars and students a highly accessible and teachable alternative to the dominant principle-based theories in the field. Raymond J. Devettere's approach is not based on an ethics of abstract obligations and duties but, following Aristotle, on how to live a fulfilled and happy life -- in short, an ethics of personal well-being grounded in prudence, the virtue of ethical decision making. In this revised fourth edition, Devettere updates most chapters, adding new cases and sections on the following: neuroscience, social psychology, overriding advance directives, studies on the fetus, the palliative care movement, cardiopulmonary resuscitation, pharmacist and reproductive issues, prenatal life and abortion, neonatal testing and mandatory vaccinations, the US government's STD research in Guatemala, the emergence of biobanks, facial transplantations, genetic testing, legal issues surrounding the Affordable Care Act, and more. Thoughtfully updated and renewed for a new generation readers, this classic textbook will be required reading for students and scholars of philosophy and medical ethics. |
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