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Books > Medicine > General issues > Medical 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.
'Astonishing' Stephen Fry 'Exceptional' Douglas Stuart, author of the Booker Prize-winning SHUGGIE BAIN 'Now is the time for this book' DBC Pierre, author of the Booker Prize-winning VERNON GOD LITTLE 'Funny. Disturbing. Brilliant' Lily Allen Funny, smart, damaged, Tom is lost in the machinery of the British mental health system, talking to a voice no one else can hear; the voice of Malamock, the Octopus God - sometimes loving, sometimes cruel, but always there to fill his life with meaning. Once an outstanding law student, Tom is now cared for by his long-suffering sister Tess, who encourages him into an experimental drugs trial that promises to silence the voice forever. The Octopus God, however, does not take kindly to being threatened... Deeply moving and tragi-comic, The Octopus Man is a bravura literary performance that asks fundamental questions about belief and love.
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.
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.
Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993."
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.
The use of human tissue for medical research and scientific
progress raises many ethical and legal challenges. The procurement,
storage and transfer of human tissue for research purposes have
posed significant questions over recent years, and a number of high
profile scandals in the UK prompted the publication of the Madden
Report on Post Mortem Practice and Procedures in Irish hospitals in
2006. Additionally, tissue-related research tends to be most
promising if samples and information are shared across national
borders, but the heterogeneity of current rules and guidelines
within the member states of the European Union calls all the more
for clarification.
As the demand for organs continues to outstrip availability and waiting lists surge, the pressure to make morally questionable, unethical decisions becomes more likely and trust in transplant medicine starts to erode. Medical ethics expert and former health professional, Trevor Stammers, analyses the complex ethical web that constitutes the worldwide exchange of organs and tissues. Key philosophical questions concerning existence, consciousness, the nature of death and the right to life connect organ donation and transplantation to real-life case studies exploring difficulties with the 'dead donor rule' for deceased donation, organ donation euthanasia, xenotransplantation and the creation of organoids and 'organs-on-chips', alongside examples of human trafficking and systematic state murder to provide organs. Controversial cases from Japan, Germany, USA and Singapore are examined alongside the Spanish, Welsh, and Chilean experience of deceased donation opt-out schemes to highlight the variety of threats and challenges to public trust in transplant medicine. Charting these examples provides valuable material for debates and discussions in the philosophy of medicine and medical ethics more generally. Stammers suggests viable alternatives to current ethical failings by focusing on the moral arguments that define public trust, moving the debate on transplant ethics in vital new directions.
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.
A 30-year-old Polish lady is admitted in labour. This is her first pregnancy and she is full term. She is in a lot of pain, her liquor is stained with meconium and the trace of her baby's heart is classified as pathological. Her grasp of English is limited. You have been asked to obtain her consent for a caesarean section... 100 Cases in Clinical Ethics and Law explores legal and ethical dilemmas through 100 clinical scenarios typical of those encountered by medical students and junior doctors in the emergency or outpatient department, on the ward or in the community setting. Covering issues such as consent, capacity, withdrawal of treatment, confidentiality and whistle-blowing, each scenario has a practical problem-solving element, encouraging readers to explore their own beliefs and values including those that arise as a result of differing cultural and religious backgrounds. Answer pages highlight key points in each case, providing advice on how to deal with the emotive issues that occur when practising medicine and guidance on appropriate behaviour. Making speedy and appropriate decisions, and choosing the best course of action to take as a result, is one of the most important and challenging parts of training to become a doctor. These true-to-life cases will teach students and junior doctors to recognize ethical and legal dilemmas as they arise, and to respond appropriately.
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.
Genetic screening technologies involving pre-implantation genetic diagnosis (PGD) raise particular issues about selective reproduction and the welfare of the child to be born. How does selection impact on the identity of the child who is born? Are children who are selected for a particular purpose harmed or treated as commodities? How far should the state interfere with parents' reproductive choices? Currently, concerns about the welfare of the child in selective reproduction have focused on the individual interests of the child to be born. This book re-evaluates the welfare of the child through the controversial topic of saviour sibling selection. Drawing on relational feminist and communitarian ethics, Michelle Taylor-Sands argues that the welfare of the child to be born is inextricably linked with the welfare of his/her family. The author proposes a relational model for selective reproduction based on a broad conception of the welfare of the child that includes both individual and collective family interests. By comparing regulation in the UK and Australia, the book maps out how law and policy might support a relational model for saviour sibling selection. With an interdisciplinary focus, Saviour Siblings: A Relational Approach to the Welfare of the Child in Selective Reproduction will be of particular interest to academics and students of bioethics and law as well as practitioners and policymakers concerned with the ethics of selective reproduction.
Psychotherapists have an ethical requirement to inform clients about their treatment methods, alternative treatment options, and alternative conceptions of their problem. While accepting the basis for this "informed consent" requirement, therapists have traditionally resisted giving too much information, arguing that exposure to alternative therapies could cause confusion and distress. The raging debates over false/recovered memory syndrome and the larger move towards medical disclosure have pushed the question to the fore: how much information therapists should provide to their clients? In Negotiating Consent in Psychotherapy, Patrick O'Neill provides an in-depth study of the ways in which therapists and clients negotiate consent. Based on interviews with 100 therapists and clients in the areas of eating disorders and sexual abuse, the book explores the tangle of issues that make informed consent so difficult for therapists, including what therapists believe should be part of consent and why; how they decide when consent should be renegotiated; and how clients experience this process of negotiation and renegotiation.
Treating disease can be considered a combat between curative therapies and pathological afflictions. As such, the action of achieving a cure can be likened to successfully waging war on sickness and bodily disorders. Surgical Philosophy applies the core principles derived from Sun Tzu's timeless book Art of War to combating disease through surgery. Its goal is to offer principles, strategies and leadership guidelines for surgeons at all levels and other healthcare practitioners who carry out interventional procedures for the ultimate aim of defeating illness and enhancing the care of patients. In providing a novel and exciting perspective on this ancient text, the book will also be of interest to students of leadership, Eastern philosophy and Chinese history. The book follows eleven sections of the Art of War. Each section reflects the messages in the Art of War, but with a modern surgical point of view. In the book, the role of the surgeon is equivalent to that of a leader or military commander, and the lessons offered in the Art of War are expanded to identify surgical principles and practice.
Giving Blood represents a new agenda for blood donation research. It explores the diverse historical and contemporary undercurrents that influence how blood donation takes place, and the social meanings that people attribute to the act of giving blood. Drawing from empirical studies conducted in the United States, Canada, France, Australia, China, India, Latin America and Africa, the book's chapters turn our attention to the evolution of blood donation worldwide, examining: the impact of technology advances on blood collection practices the shifting approaches to donor recruitment and retention the governance and policy issues associated with the establishment of blood clinics the political and legal challenges of regulating blood systems. This innovative examination moves the focus from individual explanations of rates of blood donation to a social, structural explanation. It will appeal to international scholars and students working in the areas of sociology, medical anthropology, health care, public policy, socio-legal studies, comparative politics, organizational management, health and illness, the history of medicine, and public health ethics.
In ALLOCATING HEALTH CARE RESOURCES, leading authorities and
researchers expose the basic philosophical, ethical, and economic
issues underlying the current health care debate. The contributors
wrestle with such complicated issues as whether it is ethical to
ration health care, the morality of the worldwide bias against
children in allocating health care resources, whether sin taxes can
be defended morally, and how to achieve a just health care system.
The book also includes an insightful analysis of the Clinton health
care reform plan. |
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