In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.

This volume consists of fourteen chapters selected from papers presented at the conference Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics treated are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines.

This is the first book that analyzes and systematizes all the general ideas of medicine, in particular the philosophical ones, which are usually tacit. Instead of focusing on one or two points - typically disease and clinical trial - this book examines all the salient aspects of biomedical research and practice: the nature of disease; the logic of diagnosis; the discovery and design of drugs; the design of lab and clinical trials; the crafting of therapies and design of protocols; the moral duties and rights of physicians and patients; the distinctive features of scientific medicine and of medical quackery; the unique combination of basic and translational research; the place of physicians and nurses in society; the task of medical sociology; and the need for universal medical coverage. Health care workers, medicine buffs, and philosophers will find this thought-provoking book highly useful in their line of work and research.

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.

Medical futility is a controversial issue not only in its definition but also in its application. There are few books on the subject, and those in existence mostly focus on the situation in the United States. This title, however, provides extensive international perspectives on medical futility.This book will benefit healthcare professionals as well as health policy makers around the world. It allows them to see how different countries approach the issue of medical futility and their experiences in dealing with this issue. The complexity of the issue, and in particular how some countries innovatively address it in an ethically sound manner, is clearly presented.

Privacy is an unwieldy concept that has eluded an essentialised definition despite its centrality and importance in the body of bioethics. The compilation presented in this volume represents continuing discussions on the theme of privacy in the context of genetic information. It is intended to present a wide range of expert opinion in which the notion of privacy is examined from many perspectives, in different contexts and imperatives, and in different societies, with the hope of advancing an understanding of privacy through the examination and critique of some of its evolving component concepts such as notions of what constitute the personal, the context of privacy, the significance and impact of the relational interests of others who may share the same genetic inheritance, and mechanisms for the protection of privacy (as well as of their limitations), among others. More specifically, the discussions in this volume encourages us to think broadly about privacy, as encompassing values that are entailed in the sociality of context and of relations, and also as freedom from illegitimate and excessive surveillance. A long-standing question that continues to challenge us is whether genetic information should be regarded as exceptional, as it is often perceived. A conclusion that could be derived from this volume is that while genetic information may be significant, it is not exceptionally so. The work presented in this volume underlines the continuing and growing relevance of notions of privacy to genomic science, and the need to take ownership of a genetic privacy for the future through broad, rigorous and open discussion.Contributors: Alastair V Campbell, Benjamin Capps, Jacqueline JL Chin, Oi Lian Kon, Kenji Matsui, Thomas H Murray, Nazirudin Mohd Nasir, Dianne Nicol, Anh Tuan Nuyen, Onora O'Neill, Margaret Otlowski, Yvette van der Eijk, Chunshui Wang, Ross S White.

This book delves into risks that can easily bedevil any psychotherapist and what can happen if they are ignored. Dramatic storytelling, based on actual incidents from the author's experiences as a member of ethics committees and as an ethics teacher and consultant, explores actions prompting clients to issue formal complaints. Set in the context of an ethics committee meeting over the course of a weekend, twelve psychologists face their peers who will stand in judgment. Issues include the fallout from losing one's temper with a difficult client, a personal disclosure gone terribly wrong, a bartering arrangement that literally falls apart, a private life revealed in a most public way, a vengeful act that sullies the reputation of an entire department, breaking confidentiality when a client threatened harm, and the slippery slope to sexual exploitation. The stories are absorbing, enlightening, sometimes shocking, and often stranger than fiction. Narrative nonfiction puts human faces and emotions on what would otherwise be cursory statistics. What led to the formal complaint from both the vantage point of the complainant and the psychologist offers insights not otherwise available unless the dynamics of their private lives leading up to the conflict are revealed. An author's commentary and discussion questions follow every story. Both new and seasoned practitioners, as well as those still in training, will find this to be an invaluable resource.

This book examines the question of what parental obligations procreators incur by bringing children into being. Prusak argues that parents, as procreators, have obligations regarding future children that constrain the liberty of would-be parents to do as they wish. Moreover, these obligations go beyond simply respecting a child's rights. He addresses in turn the ethics of adoption, child support, gamete donation, surrogacy, prenatal genetic enhancement, and public responsibility for children.

Many counselors learn about ethics in graduate school by applying formal, step-by-step ethical decision-making models that require counselors to be aware of their values and refrain from imposing personal values that might harm clients. However, in the real world, counselors often make split-second ethical decisions based upon personal values. Values and Ethics in Counseling illustrates the ways in which ethical decisions are values-but more than that, it guides counselors through the process of examining their own values and analyzing how these values impact ethical decision making. Each chapter presents ethical decision making as what it is: a very personal, values-laden process, one that is most effectively illustrated through the real-life stories of counselors at various stages of professional development-from interns to seasoned clinicians-who made value-based decisions. Each story is followed by commentary from the author as well as analysis from the editors to contextualize the material and encourage reflection.

This book criticizes the suggestive implication of newer bioethics that we need a new ethical paradigm in order to handle with the innovations of medicine and biotechnology. It holds that these innovations have a suggestive character at all which is not relevant however in order to justify a paradigm shift in ethics. Especially the suggestions of reproduction, genetics, mercy killing and neuroscience reveal a misunderstanding about ethics. Moreover they show inevitably theological implications they actually like to avoid especially in secular ethics.

The field of global health is expanding rapidly. An increasing number of trainees are studying and working with marginalized populations, often within low and middle-income countries. Such endeavours are beset by ethical dilemmas: mitigating power differentials, addressing cultural differences in how health and illness are viewed, and obtaining individual and community consent in research. This introductory textbook supports students to understand and work through key areas of concern, assisting them in moving towards a more critical view of global health practise.

Divided into two sections covering the theory and practice of global health ethics, the text begins by looking at definitions of global health and the field s historical context. It draws on anti-colonial and anti-racist perspectives and concepts, developing social justice and solidarity as key principles to guide students. The second part focuses on ethical challenges students may face in clinical experiences or research. Topics such as working with indigenous communities, the politics of global health governance, and the ethical challenges of advocacy are explored using a case study approach. "

An Introduction to Global Health Ethics" includes recommended resources and further readings, and is ideal for students from a range of disciplines including public health, medicine, nursing, law and development studies who are undertaking undergraduate and graduate courses in ethics or placements overseas.

Named a 2013 Doody's Core Title

The trend toward patient self-management (PSM) of chronic disease is accelerating at a rapid pace along with the evolution of home-based or mobile technologies to support this care. Yet the development of self-management practice standards and advanced practice nursing support has been haphazard. This book fills a glaring void by addressing, against a backdrop of current best practices in PSM, such questions as: What are appropriate standards of safety in PSM? How can we be assured those standards are met? How does one reach a good prognosis about whether or not patients will be able to practice PSM? What level of effectiveness and efficiency should PSM reach to be considered a good policy option?

Grounded in a clear ethical practice framework for PSM regimens, the text discusses PSM of the major chronic diseases along with best practice intervention strategies. The text maps out the implementation of the PSM framework for both patient and institution, supported by numerous case examples. Also addressed are PSM challenges to Advanced Practice Nursing, three ethically valid assessment tools, and relevant health policy concerns. Offering study questions and answers, the text is designed for course adoption and as a resource at MSN, DNP, and PhD levels Key Features:

Presents clear ethical practice framework for PSM regimens Explores PSM in the major chronic diseases along with case studies Discusses PSM challenges to Advanced Practice Nursing Provides three ethically valid assessment tools Useful for course adoption and a resource at MSN, DNP, and PhD levels

"Provides students with tools to identify the problems in heath care." "Health Care Ethics "is aclear, accessible text/reference that explores the full range of contemporary issues in health care ethics from a practical wisdom approach. The authors present the fundamental concerns of modern medical ethics--autonomy, beneficence, justice, and confidentiality--and then provide analysis, cases, and insights from professional literature to discuss them. Throughout, the discussion starts with larger issues or concepts and principles and then focuses on specific problems or complications. Learning GoalsUpon completing this book, readers will be able to:

• Identify the problems in health care ranging from end of life issues to testing and research.
• Develop a more well-rounded understanding of cultural traditions that are not a part of the mainstream discussion of American medical ethics.
• Analyze the various views on health care ethics.

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.

Fast-moving and ever-changing, stem cell science and research presents ongoing ethical and legal challenges in many countries. Each development and innovation throws up new challenges. This is the case even where new developments initially seem to solve old dilemmas. Sometimes it becomes evident that new science does not in fact solve old problems and, for that reason, the ethical issues remain. In recognition of this, this book presents innovative and creative analyses of a range of ethical and legal challenges raised by stem cell research and its potential and actual application. The editors of this collection have brought together experts from ethics and law to bring fresh perspectives on the use of and research on stem cells. The chapters in this collection range across a number of different issues in the debate on stem cells, from the ethical dilemmas of conducting stem cell research to those of the clinical application of stem cell technology. Each chapter gives an in-depth and comprehensive analysis of the ethical or legal issues at stake. The early chapters give engaging new expositions on the permissibility of using embryos in stem cell research, in particular challenging our views about how we view and construct' the embryo in debates regarding stem cells. Later chapters move on to actual and potential clinical uses of stem cells and present novel arguments about these.

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.

This volume addresses the proper character of patient informed consent to medical treatment and clinical research. The goal is critically to explore the current individually oriented approach to informed consent which grew out of the dominant bioethics movement that arose in the United States in the 1970s. In contrast to that individually oriented approach, this volume explores the importance of family-oriented approaches to informed consent for medical treatment and clinical research. It draws on both East Asian moral resources as well as a critical response to the ways in which the practice of informed consent has developed in the United States

This exciting book examines how human tissues and cells are being exchanged, commodified and commercialized by new health technologies. Through a discussion of emergent global tissue economies' the author explores the social dynamics of innovation in the fields of tissue engineering and stem cell science. The book explores how regenerative medicine configures and conceptualizes bodies and argues that the development of regenerative medicine is a feminist issue. In Regenerating Bodies, Kent critically examines the transformative potential of regenerative medicine and whether it represents a paradigm shift from more traditional forms of biomedicine. The book shows that users of these technologies are gendered and women's bodies are enrolled in the production of them in particular ways. So what is the value of a feminist bioethics for thinking about the ethical issues at stake? Drawing on extensive qualitative field research, Kent examines the issues around donation, procurement, banking and engineering of human tissues, and presents an analysis of the regulatory and policy debates surrounding these practices within Europe and the UK. The book considers the claims that regenerative medicine represents exciting possibilities for treating the diseases of ageing bodies, critically assessing what kind of futures are embodied in tissue and cell based therapies. It will be of interest to a wide range of scholars and students within the social sciences, in health technology studies, bioethics, feminist studies, and gender and health studies.

Modern medicine is one of humankind's greatest achievements.Yet today, frequent medical errors and irreproducibility in biomedical research suggest that tremendous challenges beset it. Understanding these challenges and trying to remedy them have driven considerable and thoughtful critical analyses, but the apparent intransigence of these problems suggests a different perspective is needed. Now more than ever, when we see options and opportunities for healthcare expanding while resources are diminishing, it is extremely important that healthcare professionals practice medicine wisely. In Medical Reasoning, neurologist Erwin B. Montgomery, Jr. offers a new and vital perspective. He begins with the idea that the need for certainty in medical decision-making has been the primary driving force in medical reasoning. Doctors must routinely confront countless manifestations of symptoms, diseases, or behaviors in their patients. Therefore, either there are as many different "diseases" as there are patients or some economical set of principles and facts can be combined to explain each patient's disease. The response to this epistemic conundrum has driven medicine throughout history: the challenge is to discover principles and facts and then to develop means to apply them to each unique patient in a manner that provides certainty. This book studies the nature of medical decision making systematically and rigorously in both an analytic and historical context, addressing medicine's unique need for certainty in the face of the enormous variety of diseases and in the manifestations of the same disease in different patients. The book also examines how the social, legal, and economic circumstances in which medical decision-making occurs greatly influence the nature of medical reasoning. Medical Reasoning is essential for those at the intersection of healthcare and philosophy.

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.

This book originated in an international conference on "Values in medical Decision Making" held at the University of Aarhus, Denmark, in June 1988. This was the second conference of the European Society for Philosophy of Medicine and Health Care (ESPMH), which was founded in Maastricht, the Netherlands, in 1987. ESPMH aims at promoting philosophy of medicine and health care in a wide sense and at stimulating contacts between European scholars in this field.

International illicit trade in human organs is on the increase, fueled by growing demand and unscrupulous traffickers. In order to truly understand the problem of organ trafficking, an analysis should take into account the various perspectives that come into play in this multifaceted issue. With contributions from international scholars and experts, The International Trafficking of Human Organs: A Multidisciplinary Perspective provides a broad-based exploration of this controversial phenomenon. Divided into four parts, the book examines the issue of human organ trafficking from the perspectives of criminal justice, business, medicine, ethics, philosophy, and theology. The book begins by presenting case studies of the trafficking of body parts occurring in the U.S. and Mexico. It examines the increase in organ harvesting from Chinese prisoners and describes widespread instances of trafficking in Europe. Diverse perspectives Next, it examines the economic ramifications of possible legislation of the sale of body parts and discusses other proposals for increasing the supply of kidneys and other organs. It explores ethical issues surrounding the kidney shortage and incentives to promote donation. It also offers arguments for and against compensation for transplant organs from Kantian, Dworkinian, and other perspectives. Lastly, theologians discuss opposing Catholic and Protestant perspectives on the sale of human organs. Learning tools Each chapter provides discussion questions to provoke vigorous debate and references to facilitate further study. The wide-ranging analysis provided by this volume is certain to enhance further inquiry into a disturbing and increasingly prevalent issue.

Amongst the scholars, secrets and soporifics of Victorian Oxford, the truth can be a bitter pill to swallow...Jesus College, Oxford, 1881. An undergraduate is found dead at his lodgings and the medical examination reveals some shocking findings. When the young man's guardian blames the college for his death and threatens a scandal, Basil Rice, a Jesus college fellow with a secret to hide, is forced to act and finds himself drawn into Sidney Parker's sad life. The mystery soon attracts the attention of Rhiannon 'Non' Vaughan, a young Welsh polymath and one of the young women newly admitted to university lectures. But when neither the college principal nor the powerful ladies behind Oxford's new female halls will allow her to become involved, Non's fierce intelligence and determination to prove herself drive her on. Both misfits at the university, Non and Basil form an unlikely partnership, and it soon falls to them to investigate the mysterious circumstances of Parker's death. But between the corporate malfeasance and the medical quacks, they soon find the dreaming spires of Oxford are not quite what they seem... An intriguing first installment of The Oxford Mysteries series by master crime writer, Alis Hawkins. Perfect for fans of Laura Shepherd-Robinson, Sarah Waters and Kaite Welsh. Praise for A Bitter Remedy 'Fearlessly tackles taboo attitudes of the era, taking aim at misogyny, homophobia, and sexual politics. An excellent addition to the historical mystery canon. Marvellous!' Vaseem Khan, author of Midnight at Malabar House 'A Bitter Remedy is a perfect tonic for our times.' S. G. MacLean 'Absolutely brilliant! Thoughtful, complex and engrossing' Chris Lloyd, author of The Unwanted Dead 'A superb atmospheric mystery to the last page' Rachel Lynch, author of Dark Game

Where do a doctor's responsibilities lie in communicating diagnostic and predictive genetic information to a patient's family members? On the one hand, a patient may wish to retain confidentiality while the relatives seek information; on the other, a patient may wish to share the information while the relatives would rather not know. This volume investigates the doctor's professional legal and ethical obligations in the context of these two familial tensions. The examination is conducted within the liberal-communitarian debate, whereby the two philosophies hold different perceptions of the individual and the relationship he or she has with others. Within this theoretical framework, the book examines the approach taken by English medical law and ethics to the communication of genetic information to family members. Legally, the focus is on tort law and the law of confidentiality. Ethically, it concentrates on the approach taken by the bioethical literature, and more specifically by codes of ethics and professional guidelines.

When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors-if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.