Is the advancement of scientific knowledge and the development of biomedical technologies - known as the 'New Medicine' - desirable? George P. Smith asks this fundamental question while also confronting the distribution of these scarce medical resources. Law, economics, medical science, philosophy and ethics all coalesce in this discussion of how to structure normative standards of conduct that will improve the quality of human life. The author begins by examining various economic constructs as aids for achieving a fair and equitable delivery of health care services. He then assesses their level of practical application and evaluates the costs and benefits to society of pursuing the development and use of the 'New Medicine'. The book ends with a case study of organ and tissue transplantation that illustrates the implementation of distributive justice. The author concludes that as long as clinical medicine maintains its focus on healing and alleviating suffering among patients, a point of equilibrium will be reached that advances the common good. This timely and compelling exploration will be a must-read for scholars, researchers, policymakers and all those interested in advances in medical technology and the issues surrounding access to health care.

Prior to and during the Second World War, the Japanese Army established programs of biological warfare throughout China and elsewhere. In these "factories of death," including the now-infamous Unit 731, Japanese doctors and scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese nationals. However, as a result of complex historical factors including an American cover-up of the atrocities, Japanese denials, and inadequate responses from successive Chinese governments, justice has never been fully served. This volume brings together the contributions of a group of scholars from different countries and various academic disciplines. It examines Japan's wartime medical atrocities and their postwar aftermath from a comparative perspective and inquires into perennial issues of historical memory, science, politics, society and ethics elicited by these rebarbative events. The volume's central ethical claim is that the failure to bring justice to bear on the systematic abuse of medical research by Japanese military medical personnel more than six decades ago has had a profoundly retarding influence on the development and practice of medical and social ethics in all of East Asia. The book also includes an extensive annotated bibliography selected from relevant publications in Japanese, Chinese and English.

The ethical dimensions of health communicators? interventions and campaigns are brought into question in this thought-provoking book. Examining the efforts to effect behavior change, the author questions how far health communication can and should go in changing people?s values. The author broadens the current analysis of interventions and presents conceptual frameworks that help identify values and justifications that are embedded in health communication goals, strategies, and evaluation criteria. This critical approach helps explain how and why choices are made in design and implementation, and provides constructs and frameworks to examine them. It also widens the criteria for program evaluation and policymaking, and provides practitioners, planners, policy-makers, researchers, and students with practice-oriented questions.

With an increased capacity to analyze fetal cells in the laboratory and the present possibility of monitoring human embryonic development using advanced diagnostic technique, prenatal diagnosis (PND) has become widely diffused in medical practice. The Fetus as Medical Patient emphasizes, however, that PND results are not unambiguous: they may either lead to a continuation of the pregnancy, or to an abortion. Cioffi engages the reader in a comprehensive examination of the state of the question regarding diagnosis and possible treatment of human illness in utero. The book deals with biomedical consideration in prenatal human life, presents a survey of the literature of ten North American Catholic theologians who have written on the topic of moral dilemmas in PND over the past twenty years, and critically analyzes the writings of these ten authors.

Eating disorders (EDs) have become a social epidemic in the developed world. This book addresses the close links between EDs and exercise, helping us to understand why people with EDs often exercise to excessive and potentially harmful levels. This is also the first book to examine this issue from an ethical and legal perspective, identifying the rights and responsibilities of people with EDs, heir families and the fitness professionals and clinicians that work with them.

The book offers an accessible account of EDs and closely examines the concept of addiction. Drawing on a wide range of medical, psychological, physiological, ociological and philosophical sources, the book examines the benefits and risks of exercise for the ED population, explores the links between EDs and other abuses of the body in the sports environment and addresses the issue of athletes with disordered eating behaviour. Importantly, the book also surveys current legislation and professional codes of conduct that guide the work of fitness professionals and clinicians in this area and presents a clear and thorough set of case histories and action points to help professionals better understand, and care for, their clients with EDs.

Exercise and Eating Disorders is important reading for students of applied ethics, medical ethics and the ethics of sport, as well as for fitness professionals, psychiatrists, clinical psychologists, sports coaches and sport and exercise scientists looking to improve their understanding of this important issue.

The regulation of the body provides an important concern in law, medical practice and culture. This volume contributes to existing research in the area by encouraging experts from a range of related disciplines to consider the legal, cultural and medical ways in which we regulate the body, further exploring how conceptions of self, liberalism, property and harm inform and influence contentious legal and ethical questions about what we can and cannot do to or with our own bodies.

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.

Leading bioethicists and philosophers examine and debate the question of how the health care system should deal with using complimentary and alternative medicines. The distinguished authorities writing here both defend and criticize alternative medicine, with some arguing that the medical system should change substantially in order to accommodate alternative medicine, and others claiming that virtually all alternative treatments are worthless. In the heat of the debate many fundamental issues are raised concerning our health care system, among them the questions of therapeutic effectiveness, media truthfulness, the patient's freedom to choose among treatment options, health insurance coverage, the ability of the current healthcare delivery system to meet patients' needs, and government approval of alternative medicines.

Bioethics and the Human Goods offers students and general readers a brief introduction to bioethics from a "natural law" philosophical perspective. This perspective, which traces its origins to classical antiquity, has profoundly shaped Western ethics and law and is enjoying an exciting renaissance. While compatible with much in the ethical thought of the great religions, it is grounded in reason, not religion. In contrast to the currently dominant bioethical theories of utilitarianism and principlism, the natural law approach offers an understanding of human flourishing grounded in basic human goods, including life, health, friendship, and knowledge, and in the wrongness of intentionally turning against, or neglecting, these goods. The book is divided into two sections: Foundations and Issues. Foundations sketches a natural law understanding of the important ethical principles of autonomy, non-maleficence, beneficence, and justice and explores different understandings of "personhood" and whether human embryos are persons. Issues applies a natural law perspective to some of the most controversial debates in contemporary bioethics at the beginning and end of life: research on human embryos, abortion, infanticide, euthanasia, the withdrawal of tube-feeding from patients in a "persistent vegetative state," and the definition of death. The text is completed by appendices featuring personal statements by Alfonso Gomez-Lobo on the status of the human embryo and on the definition and determination of death.

There exists today a fast growing availability of personal genetic information. Its prognostic impact and value for an individual or family member's health is sometimes unclear, whilst at other times it is clear-cut. The issue of whether to disclose genetic information does however have wide ranging implications. Avoiding the rhetoric of 'genetic exceptionalism', and drawing on an expanded field of bioethical, sociological and anthropological research, this book sets a new agenda for discussing the ethics surrounding the disclosure of prognostic genetic information. A hermeneutical approach reconsiders the ethics of disclosure in a variety of contexts in which genetic information is generated, requested, interpreted or communicated - from the provider perspective, but also from the moral perspectives of clients and their families. It is in situations of disclosure, in these different contexts, that genetic information meets morality. Providers and recipients can become vulnerable to the revelation or concealment of information, and the forms in which it may be provided. Disclosure Dilemmas invites readers to explore these contexts from an ethical viewpoint and will be a valuable resource for anyone with an interest in biomedical ethics.

Fire, flood, earthquake, famine, pestilence, and warfare are no strangers to our experience. Once, we sought to placate the gods who brought these evils upon us. Today, clinicians, engineers, and politicians replace priests, prophets, seers, and shamans, and we Americans in particular think to impose our will upon the world. In times of catastrophe, issues of good and evil surrender to rapid, nearly automatic, operational response. Yet the catastrophic event poses unavoidable moral choices, ones that are more politically and emotionally complex since 9/11 and our "War on Terrorism." This book benefits from the emergence of bioethics as it has evolved from its clinical roots to address policy, politics, and social practice far removed from that origin. At the same time, the clinical focus on narratives and cases provides a tangible center for ethical reflection. It reminds us that ethics is about persons and their choices, a perspective often lost to abstraction when ethics is left to the ministrations of academe. By treating the catastrophic event as both a category and a genre, Bioethics connects to aesthetics and so enables us to enrich ethical inquiry by ranging from pandemic, hurricane, and flood to terrorist attack."

Ethics plays an especially important and unique role in psychiatry, and this issue is a must-read for psychiatrists as they navigate these sometime tricky waters. With an eye on the most current developments in the psychiatric field, authors discuss topics such as ethics in research, ethics in clinical treatment, ethics in education, genetics, and the military. The section on clinical concerns contains separate articles on children, adults, and older patients, with special attention paid to women's mental health, forensics, addiction psychiatry, consultation/liaison psychiatry, and community psychiatry.

Although law and science have interacted for centuries, today their interactions pose enormous challenges. These challenges are reflected in issues ranging from reproductive technology and resource conservation, to genetic technology and biological warfare. The emerging dialogue is complex and requires an ongoing re-thinking of general principles, such as expert biological evidence, which features in a wide range of legal contexts, and including medical law, torts, crime and intellectual property. Studying the many ways in which law and biology come together in many areas of contemporary life, The Nexus of Law and Biology: New Ethical Challenges explores the juridical uses of biological sciences to illuminate key issues and contemporary intersections, arguing that each of several disciplines must communicate with one another, recognizing a common ground in ethics. Featuring an impressive list of contributors, this book is an invaluable reference for legal scholars, students, practising lawyers and scientists engaged with the legal system.

John Coggon argues that the important question for analysts in the fields of public health law and ethics is 'what makes health public?' He offers a conceptual and analytic scrutiny of the salient issues raised by this question, outlines the concepts entailed in, or denoted by, the term 'public health' and argues why and how normative analyses in public health are inquiries in political theory. The arguments expose and explain the political claims inherent in key works in public health ethics. Coggon then develops and defends a particular understanding of political liberalism, describing its implications for critical study of public health policies and practices. Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health.

The process of health care reforms must be based on demographic, epidemiological and economic evidence if it is to achieve the fundamental target of affordable, sustainable and efficient health care services for the entire population. Consequently, costing of health care services has become a frequently used element of health care reforms. This book presents the essentials of costing in a health economic framework and gives examples from successful costing studies done by the author in Tanzania, Vietnam and Burkina Faso. Based on these examples it demonstrates the importance of costing information for the planning and decision-making process in the field of budgeting, resource allocation, setting an insurance premium and strategic planning. The main message of this book is that costing of health care services is a valuable instrument in the fight for better 'health for all'.

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.

Originally published in 1985, this book examines the concept of death against the background of dramatic changes in medical technology. The book argues that 'brain death' can be precisely defined and that a biological concept of death such as 'brain death' can be philosophically well-grounded. It examines traditional criteria for death and various formulations of the concept of death in both medical literature and philosophical texts. Definitions of 'brain death' - some of which have become statute law - are critically examined. The author also examines ethical and social policy questions which arise out of attempts to redefine the boundaries of life.

Originally published in 1990, this study of the moral problems bound up with transplant therapy addresses a finely balanced distinction between ethical issues relating to its experimental nature on the one hand and those which arise when transplantation is routine on the other. Among the issues examined are proposals for routine cadaveric harvesting, criteria for organ and tissue procurement from living donors, foetuses, non-human animals and current ethical problems with artificial implants. Written as a contribution to practical philosophy, this book will interest ethicists and health care professionals.

Those involved in end-of-life decision making must take into account both legal and ethical issues. This book starts with a critical reflection of ethical principles including ideas such as moral status, the value of life, acts and omissions, harm, autonomy, dignity and paternalism. It then explores the practical difficulties of regulating end-of-life decisions, focusing on patients, healthcare professionals, the wider community and issues surrounding 'slippery slope' arguments. By evaluating the available empirical evidence, the author identifies preferred ways to regulate decisions and minimise abuses at the end of life, and outlines an ethical theory which can provide practical guidance for those engaged in end-of-life decisions.

In this title, drawing on insights from Continental, Feminist and Religious thought, an international team of leading scholars explore alternative approaches to medical ethics. Exploring alternative approaches to medical ethics emerging from the latest research in a broad range of philosophical disciplines and traditions, "Reconceiving Medical Ethics" brings together an international team of leading scholars to explore some of the most important topics in the field. Drawing on insights from Continental, Feminist and Religious thought that are often neglected in discussions of the field, the book takes as its focus a philosophical exploration of the doctor-patient relationship that lies at the heart of any consideration of medical ethics. From this starting point the book goes on to consider such important subjects as attitudes to the body, informed consent, paternalism and the role of the law in medicine. Including discussion of case studies in each chapter, "Reconceiving Medical Ethics" opens up new avenues for discussion of this crucial topic in practical ethics today. "Continuum Studies in Philosophy" presents cutting-edge scholarship in all the major areas of research and study. The wholly original arguments, perspectives and research findings in titles in this series make it an important and stimulating resource for students and academics from a range of disciplines across the humanities and social sciences.

This new book provides a clear and accessible analysis of the various ways in which human reproduction is regulated. A comprehensive exposition of the law relating to birth control,abortion, pregnancy, childbirth, surrogacy and assisted conception is accompanied by an exploration of some of the complex ethical dilemmas that emerge when one of the most intimate areas of human life is subjected to regulatory control. Throughout the book, two principal themes recur. First, particular emphasis is placed upon the special difficulties that arise in regulating new technological intervention in all aspects of the reproductive process. Second, the concept of reproductive autonomy is both interrogated and defended. This book offers a readable and engaging account of the complex relationships between law, technology and reproduction. It will be useful for lecturers and students taking medical law or ethics courses. It should also be of interest to anyone with a more general interest in women's bodies and the law, or with the profound regulatory consequences of new technologies.

This study is an imaginative coverage of multi-moral, ethical, and legal cultural differences and similarities for future use by students in the fields of biology, medicine, pharmacology, healthcare, and the biopharmaceutical industry. The similarities and differences in the various approaches to bioethics among nations lead us to an unavoidable conclusion: The moral dimensions of human existence cannot be captured by a single culture. It is the differentiations of multiculturalism. Moreover, the following features prove invaluable by revealing pragmatic ethical issues and problems among bioscientists, biotechnologists, biomedical clinicians, and bioresearchers: * To develop conceptual skills to integrate human dynamic innovations. * To indicate why bioethics in diverse cultures is an essential phenomenon. * To understand the increased role of the level of biotechnology through bioscientific synergy and prodigy. * To develop a framework of analysis to enable a student to discuss how bioscientific advances and biotechnological breakthroughs will change human nature. * To develop an understanding of the scope of biotechnological innovation and how it differs from the natural somatic structures. * To develop an ability to analyze and evaluate qualitative bioethical value systems for the future of the human race.

What does it mean to be a "just" and "caring" society when we have only limited resources to meet unlimited health care needs? Do we believe that all lives are of equal value? Is human life priceless? Should a "just" and "caring" society refuse to put limits on health care spending? In Just Caring, Leonard Fleck reflects on the central moral and political challenges of health reform today. He cites the millions of Americans who go without health insurance, thousands of whom die prematurely, unable to afford the health care needed to save their lives. Fleck considers these deaths as contrary to our deepest social values, and makes a case for the necessity of health care rationing decisions. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances. Fleck argues we can make health care rationing fair, in ways that are mutually respectful, if we engage in honest rational democratic deliberation. Such civic engagement is rare in our society, but the alternative is endless destructive social controversy that is neither just nor caring.

What is it like to be sued for medical malpractice? Bad medical outcomes traumatize patients but they also traumatize physicians. The litigation that often follows is a profoundly human, rather than just a legal experience. Although every physician's case is different, this book shows how each case goes through the same judicial stages of complaint, discovery, depositions, motions, and delays that lead to trial, settlement, or being dropped. It also gives doctors an understanding of how lawyers think and work to help defendants. Written by a physician and a lawyer, the book provides unique insights - through real-life stories - into the personal experience of litigation as well as recommendations for dealing with each of the legal process. It also includes up-to-date reviews of HIPAA legislation, the controversial subject of disclosure, and recent developments in the law affecting medical practitioners. Only about thirty percent of plaintiffs win their cases against doctors, but the journey from bedside to witness stand tests both the personal character and the professional skills of those accused. This well-documented book will help doctors understand and navigate the legal system while honouring their own ideals and emerging changed but stronger from the experience.

There is currently a lively debate ongoing in society about the nature of trust and the conditions necessary to establish and sustain it. Given the role of trust in bridging uncertainty, it is perhaps not surprising that as our consciousness of risk has increased, the role and nature of trust in social practices has come under growing scrutiny. These developments are particularly relevant to health because participation in health practices is arguably based on and engendered through trust. There is thus a need for empirically based research, which intelligently unravels this complexity to support all stakeholders in the health arena. This multidisciplinary volume of work addresses this gap by contributing substantively to the exploration of trust in the experience, practice and organization of health. It offers an overview of recent scholarship, based on empirical research, which explores the significance of trust in relation to key health-related issues. At the same time, this text examines conceptual themes in relation to trust more generally, including the relationship between trust and auditing, consent, expert knowledges and social capital.