Unlike the rest of the advanced industrialized world, the United States does not have a national healthcare system that guarantees that all residents have access to medical services. Over the past century a number of unsuccessful attempts have been made to create and implement a unified, coordinated healthcare system. Piecemeal progress has been made, such as with the passage of Medicare, Medicaid, and the Affordable Care Act. However, the US still has the dubious distinction of possessing the most expensive healthcare in the world as well as health-related outcomes that are shameful for a wealthy country, mostly due to the number of people who lack decent care. The continuing escalation in medical costs is also threatening the financial stability of the nation. In his first book, Rationing is Not a Four-Letter Word, Philip M. Rosoff argued that the only way to control costs is to impose rationing, and the only way to do so fairly is to have it apply to all. The key to rationing is how it is accomplished. He outlined a general approach to making rationing decisions that involved a comprehensive explication of procedural fairness and illustrated this with the real-life accepted system of solid organ allocation for transplantation. In this book, he discusses how to decide what should and should not be covered in a generous benefits plan for all. He considers a variety of ways this might be done and concludes that the most just approach is to utilize a transparent process in which experts and lay people develop a consensus on what should be covered by focusing on both clinical evidence of need and the effective and appropriate means to address those needs. He also considers the various objections and impediments to this proposal and concludes that they are obstacles that can be successfully met.

Can the ethical mission of health care survive among organizations competing for survival in the marketplace? On this question hinges not only the future of health care in the US, but that of the health care systems of all advanced countries. This book presents both an analytic framework and a menu of pragmatic answers. The team of authors, physician-ethicists from Harvard Medical School and the National Institutes of Health, worked with a consortium of health care organizations to explore some of the most challenging dilemmas in health care today: How can health plans determine medical necessity in a way that ensures quality care, controls costs, and builds trust with patients and physicians? What are the strategies for caring for vulnerable populations that meet their special neds without dramatically increasing costs? To answer these and other similar questions the authors blend ethical analysis with real-world example. The outcome is a rich analysis of the ethical challenges facing health care organizations, combined with tangible examples of exemplary methods to address these challenges. This book will help health care leaders, regulators, and policy makers incorporate exemplary practices, and the underlying themes they embody, into the very heart and soul of health care organizations.

The completion of the human genome project in 2000 dramatically emphasized the imminent success of the genetic revolution. The ethical and social consequences of this scientific development are immense. From human reproduction to life-extending therapies, from the impact on gender and race to public health and public safety, there is scarcely a part of our lives left unaffected by the impact of the new genetics. A Companion to Genethics is the first substantial study of the multifaceted dimensions of the genetic revolution and its philosophical, ethical, social, and political significance. It brings together the best and most influential contemporary writing about genethics. Newly commissioned essays from prominent figures in the current debate provide a wide-ranging and fascinating scholarly analysis of all the issues that arise from this explosive science.

Telepatients using connected objects to collect time-sensitive data about their health are not neutral carriers of diagnosable symptoms. Patients are persons, or personal beings as well as co-carers, whose personal experience, history and know-how must be acknowledged in time-sensitive telecare practices. Such practices require a relational ethics, inspired by medical ethics and an ethics of virtues, focusing on vulnerability and emotional health, to oversee telecare good practices, define a new therapeutic alliance compliant with patients' values, and reconcile the technical and human sides of telemedicine.

Discusses legal, social and moral questions surrounding abortion, euthanasia, health care rights, organ transplants, and artificial insemination.

The utilization of information and communication technologies in almost all spheres of modern society has changed the social picture in significant ways while simultaneously leading to tensions with regard to traditional ethical and legal practices-particularly given the global context of its application. Where these technologies impact on the practice and implementation of healthcare, it is vital to recognize the extent and nature of the ethical and social impact both at the level of professional practice and the patient. Ethical, Legal and Social Issues in Medical Informatics presents a fundamental compendium of research on the ethical, social, and legal issues facing the healthcare industry as it adopts information technologies to provide fast, efficient, and cost effective healthcare. An essential resource for every reference library, this comprehensive book offers a multidisciplinary perspective, drawing from the expertise of a wide variety of global industries including law, ethics, medicine, philosophy, and computer science.

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.

This timely volume illustrates how and why the fight against quackery in modern America has largely failed, laying the blame on an unlikely confluence of scientific advances, regulatory reforms, changes in the medical profession, and the politics of consumption. Throughout the 20th century, anti-quackery crusaders investigated, exposed, and attempted to regulate allegedly fraudulent therapeutic approaches to health and healing under the banner of consumer protection and a commitment to medical science. Quack Medicine: A History of Combating Health Fraud in Twentieth-Century America reveals how efforts to establish an exact border between quackery and legitimate therapeutic practices and medications have largely failed, and details the reasons for this failure. Digging beneath the surface, the book uncovers the history of allegedly fraudulent therapies including pain medications, obesity and asthma cures, gastrointestinal remedies, virility treatments, and panaceas for diseases such as arthritis, asthma, diabetes, and HIV/AIDS. It shows how efforts to combat alleged medical quackery have been connected to broader debates among medical professionals, scientists, legislators, businesses, and consumers, and it exposes the competing professional, economic, and political priorities that have encouraged the drawing of arbitrary, vaguely defined boundaries between good medicine and "quack medicine." Previously unpublished images from medical almanacs and drug advertisements sent directly to doctors Images of materials used by "quackbusters" in their public educational campaigns, including posters used by the AMA and anti-quackery pamphlets produced by governmental agencies

This is a book for anyone who has ever paused to wonder: Will cloning ever be legal? Why it is that 'saviour siblings' and sex selection provoke such strong reactions? Will there ever be such a thing as an artificial womb? Assisted reproductive technologies are unique in their capacity to challenge our assumptions and elicit passionate responses. Looking at the moral, philosophical, and legal issues surrounding cases of surrogacy, single or same-sex parenthood, retrieval of sperm from dead or dying patients, and the insemination of post-menopausal women, this book questions whether these rapidly-developing technologies are refashioning the nature of the family. The UK has played a unique role in the development and regulation of reproductive technologies, and has been at the forefront of controversy over 'saviour siblings', designer babies, reproductive cloning, and embryo research. This book provides a clear and simple account of the techniques involved in assisted reproduction and embryo research, and discusses the legal and ethical implications of some of these technologies, illustrated by compelling descriptions of real-life cases. The book also addresses the ways in which reproductive technologies are regulated, critically examining the role of the Human Fertilisation and Embryology Authority and comparing the UK's approach with that of other countries. Finally, it contemplates the possibility that some of our most deeply-held assumptions about human nature may be called into question by further developments in stem cell research and fertility treatments.

The concept of smart drug delivery vehicles involves designing and preparing a nanostructure (or microstructure) that can be loaded with a cargo. This can be a therapeutic drug, a contrast agent for imaging, or a nucleic acid for gene therapy. The nanocarrier serves to protect the cargo from degradation by enzymes in the body, to enhance the solubility of insoluble drugs, to extend the circulation half-life, and to enhance its penetration and accumulation at the target site. Importantly, smart nanocarriers can be designed to be responsive to a specific stimulus, so that the cargo is only released or activated when desired. In this volume we cover smart nanocarriers that respond to internal stimuli that are intrinsic to the target site. These stimuli are specific to the cell type, tissue or organ type, or to the disease state (cancer, infection, inflammation etc). pH-responsive nanostructures can be used for cargo release in acidic endosomal compartments, in the lower pH of tumors, and for specific oral delivery either to the stomach or intestine. Nanocarriers can be designed to be substrates of a wide-range of enzymes that are over-expressed at disease sites. Oxidation and reduction reactions can be taken advantage of in smart nanocarriers by judicious molecular design. Likewise, nanocarriers can be designed to respond to a range of specific biomolecules that may occur at the target site. In this volume we also cover dual and multi-responsive systems that combine stimuli that could be either internal or external.

Health and social care decisions, and how they impact a family, are often viewed from the perspective of the individual family member making them-for example, the role of the parent in surrogacy questions, the care of the elderly, or decisions that involve fetuses or organ donations. What About the Family? represents a concerted, collaborative effort to depart from this practice-it rather shows that the family unit as a whole is intrinsic and inseparable from patient's ethical decisions. This deeper level of thinking about families and health care poses an entirely new set of difficult questions. Which family members are relevant in influencing a patient? What is a family, in the first place? What duties does a family have to its own members? What makes an ethics of families distinctive from health care ethics, an ethic of care or feminist ethics is that it theorizes relationships characterized by ongoing intimacy and partiality among people who are not interchangeable, and remains centered on the practices of responsibility arising from these relationships. What About the Family? edited by bioethicists Hilde Lindemann, Marian Verkerk, and Janice McLaughlin, represents an interdisciplinary effort, drawing, among other resources, on its authors' backgrounds in sociology, nursing, philosophy, bioethics, and the medical sciences. Contributors begin from the assumption that any ethical examination of the significance of family ties to health and social care will benefit from a dialogue with the debates about family occuring in these other disciplinary areas, and examine why families matter, how families are recognized, how families negotiate responsibilities, how families can participate in treatment decision making, and how justice operates in families.

A host of ethical questions has arisen recently in response to the development of new reproductive technologies. This text helps students of theology, philosophy, and health studies, as well as lay readers, to find answers to these questions.

In order to facilitate an informed discussion of the many delicate ethical issues, the book first provides readers with relevant medical and scientific information. It explains in a clear and simple way, for example, what is involved in human embryo and embryonic cell stem research, infertility and its treatments, and prenatal screening and diagnosis. It also explains how the metaphysical framework, in which both Christian and secular philosophers think, relates to the scientific facts and affects the ways in which they solve ethical problems.

Throughout, the author takes a balanced approach, acknowledging his loyalty to Catholicism, yet freely exploring new options indicated by advancing biological science.

Dental hygienists and dental assistants need to be aware of current accepted legal processes related to such issues as infection control, insurance, malpractice, liability, and negligence. LEGAL AND ETHICAL CONSIDERATIONS FOR DENTAL HYGIENISTS AND ASSISTANTS provides them with strong theoretical and philosophical information concerning the legal, ethical, and management dilemmas that face the entire dental health team. Real-life examples with expert commentary and follow-up questions illustrate legal situations the dental hygienist or assistant may face.a consistent format for the most effective learning. Contains a case study at the beginning of each section to draw the student into a real-life situation that the hygienist or assistant could be faced with.Provides case study questions to stimulate students interest and promote greater discussion and understanding of difficult concepts. Includes a series of responses from experts in the field, providing a look at the cases through the eyes of professionals.Provides immediate clarification of vital legal terminology with Glossary terms and their definitions in the margins. Features author response to the case study, and answers to case study questions at the end of each section, so students can review vital information from the chapters and be sure theyve applied the information correctly to thecase study questions.Includes key words at the beginning of each chapter, so students can familiarize themselves with important legal terminology. Contains learning objectives at the beginning of each chapter to highlight important concepts the students need to comprehend.Provides a comprehensive glossary for students learning vital legal terminology.

Ethics and Risk Management in Online and Distance Behavioral Health identifies pertinent ethical challenges and ethically related risk-management issues that practitioners should consider when using digital technology to assist clients in need. The text illuminates how the use of technology is influenced by traditional ethics concepts, including informed consent, boundaries, conflicts of interest, electronic records, collegial relationships, and other issues. The text begins by discussing how practitioners today are leveraging technology to provide services to clients and the importance of continually considering the ethical issues involved in using such communication methods. It addresses the specific ethical issues involved in online counseling, telephone counseling, self-guided web-based interventions, smartphone apps, electronic social networks, and other forms of digital communication. Ethical, regulatory, and practice standards are covered, as well as challenges in integrated health and behavioral health educational settings. The final chapter is dedicated to preventing and managing ethical and legal risk. Ethics and Risk Management in Online and Distance Behavioral Health is an ideal textbook for use by students and practitioners in the counseling professions, including clinical social work, clinical psychology, mental health counseling, marriage and family therapy, and substance use disorders counseling.

The current development of biomedical ethics is a source of radical critique not only in the clinic, but also in the classroom. This volume argues that today's moral education is too abstract to be effective and would benefit from the adoption of the practical approach which is typical of biomedical ethics--thinking with cases. In presenting this approach, Radest explores various issues of moral epistemology and advocates the urgency of realism and decision in ethics. The use of a rich and complex literature drawn from biomedical ethics, pedagogy, and philosophy serves to stimulate the reader to think through the moral complexity and ambivalence of modern experience.

The ethics of creating-or declining to create-human beings has been addressed in several contexts: debates over abortion and embryo research; literature on "self-creation"; and discussions of procreative rights and responsibilities, genetic engineering, and future generations. Here, for the first time, is a sustained, scholarly analysis of all of these issues-a discussion combining breadth of topics with philosophical depth, imagination with current scientific understanding, argumentative rigor with accessibility. The overarching aim of Creation Ethics is to illuminate a broad array of issues connected with reproduction and genetics, through the lens of moral philosophy. With novel frameworks for understanding prenatal moral status and human identity, and exceptional fairness to those holding different views, David DeGrazia sheds new light on the ethics of abortion and embryo research, genetic enhancement and prenatal genetic interventions, procreation and parenting, and decisions that affect the quality of life of future generations. Along the way, he helpfully introduces personal identity theory and value theory as well as such complex topics as moral status, wrongful life, and the "nonidentity problem." The results include a subjective account of human well-being, a standard for responsible procreation and parenting, and a theoretical bridge between consequentialist and nonconsequentialist ethical theories. The upshot is a synoptic, mostly liberal vision of the ethics of creating human beings. "This is a valuable book on a fascinating topic, written by a major figure in the field. The topic of the ethics of creating people is both practically urgent, as new technologies develop for shaping human offspring, and also of great theoretical importance for ethics and meta-ethics because it engages the deepest issues, including those of moral status, the nature of justice, and identity. DeGrazia has already proved to be an important force in shaping the debate regarding these issues. Anyone writing on this topic will have to address this book head-on. The style is remarkably lucid and almost jargon-free. Given that the book is filled with complex, sustained argumentation, this is quite an accomplishment. This book will be of interest to legal scholars, philosophers working in normative ethics, meta-ethics, and bioethics, and public policy scholars." - Allen Buchanan, James B. Duke Professor of Philosophy, Duke University

Most public discussion has focused on those effects of genetic research that are considered in some way unwanted or unpleasant. For example, there has been much debate concerning the risks and the ethical appropriateness of genetic screening, gene therapy, and agricultural applications based on genetic techniques. It often claimed that genetic research may cause new problems such as genetic discrimination, stigmatization, environmental risks, or mistreatment of animals. Genes and Morality: New Essays adopts a critical attitude toward genetic research, on both a theoretical and a practical level. It presents some of the most important problems in the ethics of genetic engineering, including the questions of genetic health and disease, genetic testing, responsibility for health, patenting non-human and human life, and problems related to the disclosure of genetic information. The aim of the book is to focus on real ethical and conceptual issues. Consider, for instance, the concept of genetic disease. As one of the contributors, Ingmar Poern, writes, fear of genetic disease, or anxiety, is not itself a disease any more than fear of becoming unemployed is a disease. Alleviating such emotions is not a medical task to be discharged by drug therapy. The book also examines the philosophical foundations of these issues by discussing the most influential bioethical theories of today, including utilitarianism and principlism.

A holistic view of the factors that impact the health of a patient beyond the illness itself, this book examines what it is like to be a patient. It espouses the view that terminal illness may not be a tragedy but, an opportunity for emotional growth. The inadequacies of medical care today are discussed, from the failure of health care professionals to see the person with the disease, to the many ways in which managed-care organizations jeopardize the doctor/patient relationship.

The work reviews concrete ways in which health care professionals can enhance the quality of their care, by remaining compassionate, continuing to offer patients hope (even if their condition is terminal), acknowledging and addressing patients' suffering, and counseling patients so that they can obtain the support needed. A new advocacy role for doctors is presented that enables patients to make advised decisions about their own treatment. This book encourages patients to take back their lives from the diseases that overwhelm them. It also discusses advance directives, living wills, cardiopulmonary resuscitation, and do not resuscitate orders. Information is provided to help patients assume self advocacy on end-of-life issues from an emotional perspective as well as a legal perspective.

The use of human tissue for transplantation is becoming a billion-dollar business. This book is the first comprehensive exploration of the American tissue transplantation industry. It traces the chain of distribution of musculoskeletal tissue (e.g. bones and ligaments) and skin from the generous donation of grieving families to its transplantation into hundreds of thousands of persons each year. Commodification, commercialization, and the occasional use of tissue for "cosmetic" surgery have raised ethical questions about the acceptability of "markets" in human body parts that have been altruistically donated by families. Inevitably, questions about the informed consent and the need for responsible stewardship by the industry have been raised, often in the Press.

The book provides a comprehensive background to these ethical problems by explaining the historical development, breadth, and organization of the tissue industry, including the technical developments that have made it simultaneously clinically relevant and an attractive market for investment capital. It explores the similarities and differences in how government regulates other tissues and solid organs (such as hearts and kidneys). Contributions to the book come from an interdisciplinary group of scholars, industry representatives, government regulators, and, not least, families who have donated tissue from their dead loved ones.

Psychotherapists have an ethical requirement to inform clients about their treatment methods, alternative treatment options, and alternative conceptions of their problem. While accepting the basis for this "informed consent" requirement, therapists have traditionally resisted giving too much information, arguing that exposure to alternative therapies could cause confusion and distress. The raging debates over false/recovered memory syndrome and the larger move towards medical disclosure have pushed the question to the fore: how much information therapists should provide to their clients?

In Negotiating Consent in Psychotherapy, Patrick O'Neill provides an in-depth study of the ways in which therapists and clients negotiate consent. Based on interviews with 100 therapists and clients in the areas of eating disorders and sexual abuse, the book explores the tangle of issues that make informed consent so difficult for therapists, including what therapists believe should be part of consent and why; how they decide when consent should be renegotiated; and how clients experience this process of negotiation and renegotiation.