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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

THE TRUE CRIME BOOK OF THE YEAR AND SUNDAY TIMES TOP 10 BESTSELLER 'One of the most fascinating books I have read in a long time. Engrossing, a haunting page-turner. A book I could not put down' The Times, BOOKS OF THE YEAR __________ Meet the forensic pathologist, Dr Richard Shepherd. He solves the mysteries of unexplained or sudden death. He has performed over 23,000 autopsies, including some of the most high-profile cases of recent times; the Hungerford Massacre, the Princess Diana inquiry, and 9/11. He has faced serial killers, natural disaster, 'perfect murders' and freak accidents. His evidence has put killers behind bars, freed the innocent, and turned open-and-shut cases on their heads. Yet all this has come at a huge personal cost. Unnatural Causes tells the story of not only the cases and bodies that have haunted him the most, but also how to live a life steeped in death. Thoughtful, revealing, chilling and always unputdownable, if you liked All That Remains, War Doctor and This is Going to Hurt you'll love this. **Pre-order Dr Richard Shepherd's new book THE SEVEN AGES OF DEATH now** __________ 'Gripping, grimly fascinating, and I suspect I'll read it at least twice' Evening Standard 'A deeply mesmerising memoir of forensic pathology. Human and fascinating' Nigella Lawson 'An absolutely brilliant book. I really recommend it, I don't often say that but it's fascinating' Jeremy Vine, BBC Radio 2 'Puts the reader at his elbow as he wields the scalpel' Guardian 'Fascinating, gruesome yet engrossing' Richard and Judy, Daily Express 'Fascinating, insightful, candid, compassionate' Observer

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.

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.

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.

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.

From 1932 to 1972, the United States Public Health Service conducted a non-therapeutic experiment involving over 400 black male sharecroppers infected with syphilis. The Tuskegee Study had nothing to do with treatment. It purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects. The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of "bad blood", a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications. "Bad Blood" provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States. Now, in this revised edition of "Bad Blood", Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. "Bad Blood" was nominated for the Pulitzer Prize and was one of the "N.Y. Times" 12 best books of the year.

Narrative medicine, an interdisciplinary field that brings together the study of literature and medicine, offers both a way of understanding patient identity and a method for developing a clinician's responsiveness to patients. Scholars in narrative medicine maintain that the ability to be a close reader of texts, particularly literature, correlates with the ability to attend closely to one's patients, an ability referred to as narrative competence. While recognizing the genuine value of narrative competence in clinical encounters, and the value of narrative medicine in patient-centered care, Tara Flanagan examine the limits of self-narration for patients with cognitive and verbal deficits. In Narrative Medicine in Hospice Care: Identity, Practice, and Ethics though the Lens of Paul Ricoeur, Flanagan argues that the models of selfhood and care found in the work of Paul Ricoeur can offer a framework for clinicians, caregivers, and end-of-life patients regardless of their verbal and cognitive capabilities. In particular, Ricoeur's concept of the life-plan connects with the narrative method of life review in hospice and palliative care, and patient identity is a way to discuss religious and spiritual dimensions of patient experience.

Patient-centered care for chronic illness is founded upon the informed and activated patient, but we are not clear what this means. We must understand patients as subjects who know things and as agents who do things. Bioethics has urged us to respect patient autonomy, but it has understood this autonomy narrowly in terms of informed consent for treatment choice. In chronic illness care, the ethical and clinical challenge is to not just respect, but to promote patient autonomy, understood broadly as the patients' overall agency or capacity for action. The primary barrier to patient action in chronic illness is not clinicians dictating treatment choice, but clinicians dictating the nature of the clinical problem. The patient's perspective on clinical problems is now often added to the objective-disease perspective of clinicians as health-related quality of life (HRQL). But HRQL is merely a hybrid transitional concept between disease-focused and health-focused goals for clinical care. Truly patient-centered care requires a sense of patient-centered health that is perceived by the patient and defined in terms of the patient's vital goals. Patient action is an essential means to this patient-centered health, as well as an essential component of this health. This action is not extrinsically motivated adherence, but intrinsically motivated striving for vital goals. Modern pathophysiological medicine has trouble understanding both patient action and health. The self-moving and self-healing capacities of patients can be understood only if we understand their roots in the biological autonomy of organisms. Taking the patient as the primary perceiver and producer of health has the following policy implications: 1] Care will become patient-centered only when the patient is the primary customer of care. 2] Professional health services are not the principal source of population health, and may lead to clinical, social and cultural iatrogenic injury. 3] Social justice demands equity in health capability more than equal access to health services.

On Christmas day in 1956, a woman gave birth to a baby girl without ears. She was the first living victim of the notorious Thalidomide epidemic, of which there would go on to be over 10,000 more in forty-six countries across the world. By the time Frances Kelsey received the New Drug Application at the Food and Drug Administration, pregnant women had been taking Thalidomide for almost three years to cure nausea and insomnia, and sales had soared into the millions. Yet Kelsey was sceptical about the potential toxicity of this this 'wonder drug,' and so began a fastidious nineteen-month-long battle to block its approval. A tale of recklessness and greed, courage and heroism, The Gatekeeper is as timely now as it was sensational then. It documents a dramatic moment in history when countless lives were saved - not by governing bodies and elected officials, but by a lone female scientist who fought against powerful interests to expose the truth and prevent such a tragedy from ever recurring. The story of Thalidomide marks a key turning point in the $1 trillion industry that still underpins our lives today and is emblematic of the seemingly endless battle between corporation and consumer protection.

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.

Experimentation on animals and particularly humans is often assumed to be a uniquely modern phenomenon. But the ideas and attitudes that encourage the biological and medical sciences to experiment on living creatures date from the earliest expression of Western thought. In "Animal and Human Experimentation," Anita Guerrini looks at the history of these practices from vivisection in ancient Alexandria to present-day battles over animal rights and medical research employing human subjects.

Guerrini discusses in-depth key historical episodes in the use of living beings in science and medicine, including the discovery of blood circulation, the development of smallpox and polio vaccines, and recent AIDS research. She also explores the rise of the antivivisection movement in Victorian England, the modern animal rights movement, and current debates over gene therapy. In this highly accessible text, we learn how our understanding of an animal's capacity to feel pain has evolved. Guerrini reminds us that the ethical values of science seldom stray far from those of the society in which scientists live and work.

Ethical questions about the use of animals and humans in research remain among the most vexing within both the scientific community and society at large. These often rancorous arguments have gone on, however, with little awareness of their historical antecedents. "Animal and Human Experimentation" offers students and concerned general readers on every side of this debate a context within which to understand more fully the responsibility we all bear for the suffering inflicted on other living beings in the name of scientific knowledge.