A Philosophical Disease extends the bondaries of bioethics discourse both in terms f philosophical argumentation and in the range of clinical material that informs the work. The book contains a series of essays, some previouslypublished, some not. A series of unifying themes run through the chapters, linking together the diverse studies into a connected whole. Elliot cobers such topics as deaf culture. hermaphrodites, personality disorders, and heart transplants. Elliot often turns to literature as a source of explication, examing work by Paul Auster, H.G.Wells, Graham Green and others.

Healthcare management is a burning issue at the moment and this timely and topical book explores the ethical issues that arise in the context of healthcare management. Among the topics discussed are healthcare rationing, including an exposition and defence of the Qaly criterion of healthcare rationing and an examination of the contribution that ethical theory can make to the rationing debate, an analysis of how managers can be preoccupied with the goals of management and the values of doctors simultaneously, an outline of potential guidelines towards formulating a cohesion of healthcare management and ethical management and a reassessment of the role of healthcare professionals. Ethics and Values in Healthcare Management provides a valuable and much needed analysis of the ethical problems associated with healthcare management and offers some solutions towards ameliorationg healthcare organisations.

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This volume is an exploration of the ethical issues raised by health insurance, which is particularly timely in the light of recent advances in medical research and political economy. Focusing on a wide range of areas, such as AIDS, genetic engineering, screening and underwriting, new disability legislation and the ethics of private and public health insurance, this comprehensive and sometimes controversial book provides an essential survey of the key issues in health insurance. Divided into two parts, the first considers the ethics of underwriting, risk assessment and the acceptance and refusal of insurance risk by insurers. Discussing the unjust treatment of high-risk applicants, the authors identify sources of unfairness to both parties of the insurance contract, indicating how reasonable trade-offs can be made. The second part considers the argument for a mix of public and private insurance for acute and long-term care, offering recommendations for changes in the balance of social insurance, and discussing the shift toward long-term contracts in private health care and pension insurance.

This volume is an exploration of the ethical issues raised by health insurance, which is particularly timely in the light of recent advances in medical research and political economy. Focusing on a wide range of areas, such as AIDS, genetic engineering, screening and underwriting, new disability legislation and the ethics of private and public health insurance, this comprehensive and sometimes controversial book provides an essential survey of the key issues in health insurance. Divided into two parts, the first considers the ethics of underwriting, risk assessment and the acceptance and refusal of insurance risk by insurers. Discussing the unjust treatment of high-risk applicants, the authors identify sources of unfairness to both parties of the insurance contract, indicating how reasonable trade-offs can be made. The second part considers the argument for a mix of public and private insurance for acute and long-term care, offering recommendations for changes in the balance of social insurance, and discussing the shift toward long-term contracts in private health care and pension insurance.

With the success of organ transplantation and the declining number of heart beating cadaver doctors, the number of patients awaiting a transplant continues to rise. This means that alternative sources of donors have been sought, including donors after cardiac death. Such donors sustain rapid damage to their organs due to ischaemia, and as a consequence, some organs do not work initially and some none at all. The proportion of such transplants has increased dramatically in recent years--25% of kidney transplants in the UK were from such donors in 2006, highlighting how much progress has been made.
Written by international experts, this book lays out the moral, legal, and ethical restraints to using such donors for organ transplant together with the techniques that have been adpoted to improve their outcome. The different approaches and results of renal transplant according to country are covered together with the procedures and outcomes adopted to use other organs, notably the liver and lungs.

The title of this book derives from C. Wright Mills' classic The Sociological Imagination (Penguin, 1970), in which he sees the essential project of social science as the use of the imagination to 'grasp history and biography and the relations between the two in society'. This enables the social scientist to 'range from the most impersonal and remote transformations to the most intimate features of the human self'. Another of Mills' concerns was the relationship between 'the personal troubles of the milieu' and 'the public issues of social structure' and these are most acutely illustrated in human genetics, the most personal of the new technologies. The chapters in this volume address these issues through discussions of choice and informed decision-making, risks and hazards, the economic and political organization of new technology, and the public as well as the scientist's understanding of science. The methods used range from detailed ethnographies, through deconstruction's of text and action, to surveys and interviews.

Acres of Skin sheds light on a dark episode in American medical history. From the mid-1950s to the mid-1970s, inmates at Philadelphia's Holmesburg Prison were used, in exchange for a few dollars, as guinea pigs in a host of medical experiments. Drawing on in-depth interviews with dozens of prisoners as well as the doctors and prison officials who, respectively, performed and enforced these tests, Allen M. Hornblum paints a harrowing portrait of medical abuse, moral indifference, and stark greed.
Acres of Skin raises provocative questions about human rights, prison treatment, and medical and research ethics as he exposes what really happened behind the locked doors of this American prison. The book answers the question: were there other prisons like this?

Narratives have always played a prominent role in both bioethics and medicine; the fields have attracted much storytelling, ranging from great literature to humbler stories of sickness and personal histories. And all bioethicists work with cases--from court cases that shape policy matters to case studies that chronicle sickness. But how useful are these various narratives for sorting out moral matters? What kind of ethical work can stories do--and what are the limits to this work? The new essays in "Stories and Their Limits" offer insightful reflections on the relationship between narratives and ethics.

Series Information:
Reflective Bioethics

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

Drawing on postmodernist analyses, Leaky Bodies and Boundaries presents a feminist investigation into the marginalization of women within western discourse that denies both female moral agency and embodiment. With reference to contemporary and historical issues in biomedicine, the book argues that the boundaries of both the subject and the body are no longer secure. The aim is both to valorise women and to suggest that 'leakiness' may be the very ground for a postmodern feminist ethic.
The contribution made by Leaky Bodies and Boundaries is to go beyond modernist feminisms to radically displace the mechanisms by which women are devalued. The anxiety that postmodernism cannot yield an ethics, nor advance feminist concerns is addressed. This book will provide invaluable reading for those studying sociology, women's studies and cultural studies.

Cultivating Moral Character and Virtue in Professional Practice is a pioneering collection of essays focused on the place of character and virtue in professional practice. Professional practices usually have codes of conduct designed to ensure good conduct; but while such codes may be necessary and useful, they appear far from sufficient, since many recent public scandals in professional life seem to have been attributable to failures of personal moral character. This book argues that there is a pressing need to devote more attention in professional education to the cultivation or development of such moral qualities as integrity, courage, self-control, service and selflessness. Featuring contributions from distinguished leaders in the application of virtue ethics to professional practice, such as Sarah Banks, Ann Gallagher, Geoffrey Moore, Justin Oakley and Nancy Sherman, the volume looks beyond traditional professions to explore the ethical dimensions of a broad range of important professional practices. Inspired by a successful international and interdisciplinary conference on the topic, the book examines various ways of promoting moral character and virtue in professional life from the general ethical perspective of contemporary neo-Aristotelian virtue theory. The professional concerns of this work are of global significance and the book will be valuable reading for all working in contemporary professional practices. It will be of particular interest to academics, practitioners and postgraduate students in the fields of education, medicine, nursing, social work, business and commerce and military service.

Does one need to be a doctor to deliver a baby, or to determine which types of lenses best correct myopic vision? Should only doctors perform physical examinations, or administer anesthesia, or determine when a patient should be discharged from the hospital? These provocative questions strike at the very heart of what it means to be a doctor. Do We Still Need Doctors? offers an incisive look at the doctor's shifting roles and responsibilities in our rapidly changing health care system. Exploring such issues as the structure of medical education, the corporatization of health care, and the increasing constraints upon the private doctor/patient relationship, John Lantos reveals how changes in our health care system are engendering new ways of understanding and responding to illness.
In addition to compelling firsthand accounts from his own medical practice, Lantos covers issues ranging from the growing emphasis on technology as healer and the physicians new role in the team-oriented health care system to the economic forces governing medicine and the limits of moral responsibility for patient care.
IDo We Still Need Doctors? probes the factors transforming the roles of doctors and health care institutions as well as our own understanding of health and healing.

The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging issues such as climate change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation.

This book is the first comprehensive examination of medical ethics in the Renaissance. It investigates the ethical considerations, evaluations of procedures, and techniques of problem-solving in the writings of European physicians and surgeons from the mid-sixteenth through the mid-seventeenth centuries.

While much of the medical practice and literature of the Renaissance remained a continuation or reinterpretation of ancient medicine, Winfried Schleiner reveals an emerging self-conscious field of medical ethics that should be considered modern, as it increasingly separates medicine from theology, the cure of the body from that of the soul. The exceptions to this trend appear in the discussions of certain sexual topics, such as masturbation, by physicians close to the Counter-Reformation. Analyzing the writings of Protestant, Catholic, and Jewish physicians -- the latter developed the most secular medical ethics of the era -- he probes the dominant and emerging philosophical ideas together with conceptions of the role of physicians and of physical well-being.

Schleiner selects several topics to explore the development of ethical ideas in depth: placebos and the broader issue of lying to patients; the treatment of hysteria; masturbation; and the prevention of sexually transmitted diseases -- subjects that are still highly charged moral as well as medical topics today.

This pioneering study will be of value to ethicists and to historians of science, medicine, and Renaissance and gender studies.

Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational moral repugnance of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.

In treatment, the psychotherapist is in a position of power. Often, this power is unintentionally abused. While trying to embody a compassionate concern for patients, therapists use accepted techniques that can inadvertently lead to control, indoctrination, and therapeutic failure. Contrary to the stated tradition and values of psychotherapy, they subtly coerce patients rather than respect and genuinely help them. The more gross kinds of patient abuse, deliberate ones such as sexual and financial exploitation, are expressly forbidden by professional organizations. However, there are no regulations discouraging the more covert forms of manipulation, which are not even considered exploitative by many clinicians. In this book, noted psychiatrist Theo. L. Dorpat strongly disagrees. Using a contemporary interactional perspective Dorpat demonstrates the destructive potential of manipulation and indoctrination in treatment. This book is divided into three parts. Part I explores the various ways power can be abused. Part II examines eleven treatment cases in which covert manipulation and control either caused analytic failure or severely impaired the treatment process. Cases discussed include the analyses of Dora and the Wolf Man by Freud, the two analyses of Mr. Z by Kohut, as well as other published and unpublished treatments. An interactional perspective is used to examine the harmful short- and long-term effects of using indoctrination methods as well as to unravel conscious and unconscious communications between therapists and patients that can contribute to manipulations. Part III shows readers how to work using a non-directive, egalitarian approach in both psychoanalytic psychotherapy and psychoanalysis.

The rhetoric of "needs" has been used to legitimate all major turns in UK health policy since 1938. This study identifies the ethical, policy, and technical issues arising from the concept of needs. In the first part a theory of needs is developed, which takes into account both the philosophical traditions and the practical problems arising in daily health care. In a second part, health systems throughout the world are described and compared, addressing ethical as well as economic querstions. Its interdisciplinary approach will make "The Need for" "Health Care" important reading not only for students of philosophy, but also for those interested in or employed in the health sector.

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.

Studies involving children with mental, emotional, or behavioral problems--or their families--have to meet certain standards of research ethics. This book contains chapters on the kinds of ethical dilemmas that typically occur in different types of studies of children, and then presents 65 real-world cases from experts who study children's mental health. These experts offer practical suggestions for how to handle these dilemmas. Chapters on the perspectives of parents, regulators, and bioethicists provide additional points of view on these issues. Written in down-to-earth language, this book will be useful for professionals who study children, for those who train students in research methods, and for parents who are thinking about participating in research studies.
In attempting to bridge the apparent gap between ethics and science, the editors close this volume on a note commonly sounded by researchers: more research is needed. Yet in this area, a new kind of research is required. The science of scientific ethics must be developed and expanded, and better understanding of the determinants and circumstances under which children can comprehend and evaluate risks and benefits is needed. Likewise, fuller knowledge of the contextual factors affecting children's and families' consent to participate in research is essential. In particular, development of scales to assess children's ability to comprehend risk-benefit issues, studies of families' reactions to research procedures, and empirical data on the impact of various forms of participant reimbursement will advance both science and ethics. This volume should spur further research, serving as a guide for current investigators, participating families, institutional review boards, and policymakers who shape the research enterprise.

Published in 2004, this collection will encourage and foster informed discussion of key issues as society comes to grips with the implications of genetic engineering, the mapping and sequencing of the human genome, and the advent of the post-genomic era. The contributors are prominent social scientists, health specialists, journalists, bioethicists and commercial representatives from the UK, Finland, Germany, Holland and Norway who are at the leading edge of current research. the book will therefore appeal to the interested public, health and other professionals, teachers and students. This book was originally published as part of the Cardiff Papers in Qualitative Research series edited by Paul Atkinson, Sara Delamont and Amanda Coffey. The series publishes original sociological research that reflects the tradition of qualitative and ethnographic inquiry developed at Cardiff. The series includes monographs reporting on empirical research, edited collections focussing on particular themes, and texts discussing methodological developments and issues.

This unique collection focuses on the legal and ethical issues surrounding the medico-legal management of death. Each chapter throws up new and unusual problems in this area, highlighting the tension between personal autonomy and medical responsibility. The book thus charts a way through the moral minefield.

In Reproduction, Technology, and Rights, philosophers and ethicists debate the central moral issues and problems raised by today's revolution in reproductive technology. Leading issues discussed include the ethics of paternal obligations to children, the place of in vitro fertilization in the allocation of health care resources, and the ethical implications of such new technologies as blastomere separation and cloning. Also considered are how parents and society should respond to knowledge gained from prenatal testing and whether or not the right to abort should relieve men of the duty to support unwanted children.
Reproduction, Technology, and Rights illuminates the moral and ethical choices that our society faces because of advances in reproductive technology and helps to make those decisions better informed.

Phil Fennell's tightly argued study traces the history of treatment of mental disorder in Britain over the last 150 years. He focuses specifically on treatment of mental disorder without consent within psychiatric practice, and on the legal position which has allowed it.
Treatment Without Consent examines many controversial areas: the use of high-strength drugs and Electro Convulsive Therapy, physical restraint and the vexed issue of the sterilisation of people with learning disabilities. Changing notions of consent are discussed, from the common perception that relatives are able to consent on behalf of the patient, to present-day statutory and common law rules, and recent Law Commission recommendations.
This work brings a complex and intriguing area to life; it includes a table of legal sources and an extensive bibliography. It is essential reading for historians, lawyers and all those who are interested in the treatment of mental disorder.

eBook available with sample pages: 0203417895