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.

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.

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.

This book provides healthcare and legal practitioners and students at all levels with the theory and practical application necessary to understand and apply bioethics, human rights and health law to their present and future work. The topics of bioethics, human rights and health law are part of the core curriculum for all students in Health Sciences in South Africa. Bioethics, Health Law and Human Rights: Principles and Practice, therefore, comes at no better time.

As the book is a guide, it does not deal exhaustively with the topics discussed. Instead, it aims to give healthcare and legal practitioners some general guidelines which it is hoped will be of practical use to them.

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.

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.

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.

This book examines the issue of ethics in the context of the provision of military health care in an epidemic. Outbreaks of epidemics like Ebola trigger difficult ethical challenges for civilian and military health care personnel. This book offers theoretical reflections combined with reports from recent military and NGO missions in the field. The authors of this volume focus on military medical ethics adding a distinct voice to the topic of epidemics and infectious diseases. While military health care personnel are always crucially involved during disaster relief operations and large-scale public health emergencies, most of the current literature treats ethical issues during epidemics from a more general perspective without taking into account the specifics of the military context. The contributions in this volume provide first-hand insights into some of the ethical issues encountered by military health care personnel in missions during the Ebola outbreak in 2014/2015. This practical perspective is complimented by academic analyses and theoretical reflections on ethical issues associated with epidemics. This book will be of much interest to students of military studies, ethics and African politics.

With the rigor of a dedicated scholar and the passion of a committed activist, Nancy Lublin offers a fresh perspective on the ethical dimensions of providing and using reproductive technologies, including contraception, assisted conception, and antenatal and childbirth interventions. Combining feminist philosophy and legal theory, Lublin considers these issues under a single category that she calls 'technological intervention in the womb.' She addresses the positions of technophiles (who advocate acceptance of technological intervention in the womb as a source of liberation), technophobic feminists (who reject artificial invasions as anti-natural and anti-women), and other feminists who have argued that technological intervention in the womb should be legal and available to women because freedom of choice should be gender-neutral. Lublin identifies core principles that are common to a kaleidoscope of feminist theories, and she argues that a materialist feminism provides the most effective framework for establishing public policy and creating social change in the name of gender justice.

The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine.* Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology* Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues* Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality* Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy.

An easy to understand text, which at the same time reflects contemporary health care practice, emphasising inter-professional care and cultural sensitivity to clients or patients. Discussing common ethical problems in all aspects of interdisciplinary clinical practice and presents both sides of any ethical issue. Case studies throughout make ethical issues applied and relevant to your clinical practice, so that you can understand how you can apply ethics in everyday situations including Primary Care, Mental Health, Complex Care The book is packed with activities and pointers on professional development, and contains advice on keeping a reflective journal.

This seminal collection on the ethical issues associated with infectious disease is the first book to correct bioethics' glaring neglect of this subject.

Timely in view of public concern about SARS, AIDS, avian flu, bioterrorism and antibiotic resistance.
Brings together new and classic papers by prominent figures.
Tackles the ethical issues associated with issues such as quarantine, vaccination policy, pandemic planning, biodefense, wildlife disease and health care in developing countries.

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.

Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs.

This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise - both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole?

These questions are addressedby applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to alarge number of ongoing and proposed screening programs whichmakes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public."

This book explores patient safety themes in developed, developing and transitioning countries. A foundation premise is the concept of 'reverse innovation' as mutual learning from the chapters challenges traditional assumptions about the construction and location of knowledge. This edited collection can be seen to facilitate global learning. This book will, hopefully, form a bridge for those countries seeking to enhance their patient safety policies. Contributors to this book challenge many supposed generalisations about human societies, including consideration of how medical care is mediated within those societies and how patient safety is assured or compromised. By introducing major theories from the developing world in the book, readers are encouraged to reflect on their impact on the patient safety and the health quality debate. The development of practical patient safety policies for wider use is also encouraged. The volume presents a ground-breaking perspective by exploring fundamental issues relating to patient safety through different academic disciplines. It develops the possibility of a new patient safety and health quality synthesis and discourse relevant to all concerned with patient safety and health quality in a global context.

Approximately two-thirds of deaths in the United States involve a doctor's partnership with an individual, whether it be for the administration of pain relief or sedation or for the act of discontinuing or not beginning life-sustaining treatment. In "A Midwife through the Dying Process," Timothy Quill, M.D., explores that partnership and the complex end-of-life issues that surround physician-assisted death. Here are the stories of nine individuals and their very different endings, common only in each person's struggle to confront issues of law and ethics and to realize a "good"death.

As more and more people survive into old age, the burden of caring for them becomes greater and greater. Although it is now possible to alleviate many of the afflictions that beset mankind, no society can afford to pay for all the healthcare that is now available or technically possible. People working in healthcare increasingly have to do more with less. Rationing takes many forms, mostly covert, and the less privileged in most societies end up struggling to get their proper share of the available healthcare resources. All too often, those in the front-line have to deal with the consequences of this 'rationing by default': healthcare professionals find themselves rushed off their feet simply doing the basic tasks and completing all the paperwork; placing frail, sick people in ever lengthening queues, sometimes asking them to wait for hours in the middle of the night under uncomfortable and even unsafe conditions; and, worst of all, working under conditions they would rather avoid in which the safety margin for those they are caring for has been greatly diminished. We are all aware that under these conditions the chance of making a mistake which can seriously harm or even lead to the death of a patient is greatly increased. But what can be done about this? How can you be sure that you are doing the right thing when faced with having to practise an uncertain science on vulnerable patients in a complex system under ever-changing conditions? At what point could you cross the invisible line from reasonable to irresponsible or unethical behaviour by tolerating conditions or tacitly accepting practices which may be regarded as unacceptable, even though you may have little immediate control over them? This book is a guide to getting it right for healthcare professionals. It is about doing the right thing, in the right way, at the right time, for the right people. These are the dimensions of quality in healthcare, and although some are in conflict (equitable access and efficiency, for example), adherence to ethical practice and professional behaviour will help lead healthcare practitioners through the minefield of responsibilities and priorities. Real-life situations are integral to the book, with over 500 clinical examples referred to within the text.

As more and more people survive into old age, the burden of caring for them becomes greater and greater. Although it is now possible to alleviate many of the afflictions that beset mankind, no society can afford to pay for all the healthcare that is now available or technically possible. People working in healthcare increasingly have to do more with less. Rationing takes many forms, mostly covert, and the less privileged in most societies end up struggling to get their proper share of the available healthcare resources. All too often, those in the front-line have to deal with the consequences of this 'rationing by default': healthcare professionals find themselves rushed off their feet simply doing the basic tasks and completing all the paperwork; placing frail, sick people in ever lengthening queues, sometimes asking them to wait for hours in the middle of the night under uncomfortable and even unsafe conditions; and, worst of all, working under conditions they would rather avoid in which the safety margin for those they are caring for has been greatly diminished. We are all aware that under these conditions the chance of making a mistake which can seriously harm or even lead to the death of a patient is greatly increased. But what can be done about this? How can you be sure that you are doing the right thing when faced with having to practise an uncertain science on vulnerable patients in a complex system under ever-changing conditions? At what point could you cross the invisible line from reasonable to irresponsible or unethical behaviour by tolerating conditions or tacitly accepting practices which may be regarded as unacceptable, even though you may have little immediate control over them? This book is a guide to getting it right for healthcare professionals. It is about doing the right thing, in the right way, at the right time, for the right people. These are the dimensions of quality in healthcare, and although some are in conflict (equitable access and efficiency, for example), adherence to ethical practice and professional behaviour will help lead healthcare practitioners through the minefield of responsibilities and priorities. Real-life situations are integral to the book, with over 500 clinical examples referred to within the text.

In this book, Susanne Lundin explores the murky world of organ trade. She tracks exploited farm workers in Moldova, prosecutors in Israel and surgeons in the Philippines. Utilizing unique source material she depicts a rapidly growing organ market characterized by both advanced medical technology and human trafficking.

Since the therapeutic value of umbilical cord blood (UCB) stem cells was first recognised in the late 1980s, there has been a proliferation of both public and private UCB banks worldwide. However, the ability to utilise such a potentially valuable resource has provoked a number of controversies. In a distinctly accessible style, this book unpacks the socio-legal implications of the UCB collection process and constructs a detailed analysis of the law and ethics that surrounds UCB banking in the UK, including ownership of the cells. Its enquiry is located within the theoretical framework of altruism versus self-interest and explores the notions of risk and choice associated with this distinctive blend of public/private healthcare provision. The book evaluates the impact of the Human Tissue Act 2004 and the European Union Tissues and Cells Directive (2004/23/EC) on the UCB industry and provides a unique insight into the effect that the law may have on the NHS whose maternity staff and premises are used to collect UCB. This book would be of interest primarily to a UK readership in addition to expectant families, health professionals, students, academics, practitioners and the UCB industry elsewhere in the world.

A selection of philosophical writings can be daunting to the uninitiated in the field of philosophy. Michael Palmer makes the process of becoming acquainted with philosophical texts smoother in this practical coursebook. Designed to equip students of clinical school and nursing with essential ethical awareness for medical dilemmas, this guide to reflecting upon moral medical problems covers an impressive scope. Controversial issues, including: euthanasia, abortion, vivisection, human-testing and behaviour control, are examined in considerable detail, as well as issues such as the right to self-determination and the limits of confidentiality. Students are invited to explore each issue with the use of philosophical questions. The very concept of ethics is investigated and chapters on egoism, utilitarianism, Kant's theories, determinism and meta-ethics are included. The discussion extends into the relatively unexplored area of cutting-edge genetic research and gives readers a sense of how existing thinking can be applied when new developments arise. Each topic is lucidly introduced and then examined in more depth through extracts taken from such major ethical thinkers as James Rachels, Sissela Bok and Peter Singer. Case-studies are provided so that the student can place often overwhelming philosophical theories in context. This demonstrates how philosophy is still very much applicable to the present-day. Hypothetical questions test the student's understanding and comprehension questions demand evaluation of the text. In addition, a detailed bibliography at the end of each chapter provides opportunities for further research and reading. This informative introduction to ethical awareness provides the reader with vital theoretical tools for the management of real medical concerns. Although aimed primarily at students, it will also prove a valuable, thought-provoking resource for doctors, nurses, paramedics, those employed in healthcare management, and members of the public concerned with the ethics of medical practice.

This book explores the ethical dilemma clinicians may face when disclosing a diagnosis of atypical sex. The moment of disclosure reveals an epistemic incompatibility between scientific fact and social meaning in relation to sex. Attempting to assess the bio-psychosocial implications of this dilemma highlights a complex historic antagonism between fact and meaning making satisfactory resolution of this dilemma difficult. Drawing on David Hume, WVO Quine and Michel Foucault the author presents an integrative model, which views scientific fact and social meaning as codetermining threads in one fabric of knowledge. From this epistemic perspective, the ethical dilemma is understood as a tear in the fabric signifying a rupturing of ontological integrity. To mend this tear and resolve the ethical dilemma three metaphysical perspectives are considered: essentialism, naturalism and emergentism. The book's unique features include: an exploration of the impact of diagnostic disclosure on people with atypical sex (intersex); a synthesis of the epistemic perspectives of social and natural science facilitating interdisciplinary collaboration; a critical evaluation of three metaphysical perspectives on atypical sex (intersex); the application of Hume's epistemological and moral distinctions to contemporary biomedicine and bioethics. The book's target audience includes academics, students and professionals whose work intersects the natural and social sciences, and individuals interested in the metaphysics, epistemology and meta-ethics of sex.

Commercial pharmaceutical companies have been much criticised for their activities yet, at the same time, there is relatively little ethical information available to those working in the industry. This book addresses this need and develops pharmaceutical ethics as a field independent to medical ethics in general.

The combined experience of authors drawn from around Europe and the United States, currently working within and outside the Pharmaceutical industry, gives this book wide appeal. It should be read by anyone interested in the production and use of pharmaceuticals in contemporary society, be they established pharmaceutical scientists, pharmacy and medical practitioners, students just entering the profession, or interested lay persons.

Topics covered include:

• Ethical theory and the relationship between theory and real life decision-making

• The concept of informed consent

• The moral and political problems surrounding the use of pharmaceuticals in wider society

• The ethical responsibility in the choice of pharmaceutical agents and the cost of medicine related problems

• Ethical dilemmas of advertising, reimbursement and the affordability of medicines

• The ethical responsibility to the patient