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Books > Medicine > General issues > Medical ethics
This book explores the development of hybrid corn, the history of eugenics, human genetics, the nature-nurture debate, the origins of the Marxian concept of proletarian science, the shift in the meaning of "fitness" in evolutionary theory, the practice of normal science in Nazi Germany, and the making and selling of science textbooks. While the topics are diverse, a common theme unites them -- each explores links between biological science, social power, and public policy.
Learning medical professionalism is a challenging, evolving, and life-long endeavor. Professionalism in Medicine: A Case-Based Guide for Medical Students helps begin this process by engaging students and their teachers in reflection on cases that resonate with the experiences of life in medicine. Through the book's seventy-two cases, commentaries, videos, and literature-based reviews, students explore the many challenging areas of medical professionalism. Readers will appreciate the provocative professionalism dilemmas encountered by students from the pre-clinical years and clinical rotations and by physicians of various specialities. Each case is followed by two commentaries by writers who are involved in health care decisions related to that case, and who represent a wide variety of perspectives. Authors represent 46 medical schools and other institutions and include physicians, medical students, medical ethicists, lawyers, psychologists, nurses, social workers, pharmacists, health care administrators, and patient advocates.
Bonnie Steinbock presents The Oxford Handbook of Bioethics - an
authoritative, state-of-the-art guide to current issues in
bioethics.
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.
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.
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.
Disaster medicine has occupied an increasingly important niche within the specialty of emergency medicine over the latter half of the 20th century. Regardless of whether an event was natural, anthropogenic, or a combination of both, emergency medicine was and is the ideal discipline to develop the human resources, the strategies, the tactics, and the evidence- based research to elevate the field of disaster medicine. It began, organizationally speaking, with Hurricane Hugo in 1989 and it is continuing through the 2019 COVID- 19 pandemic and beyond. Now that we are well into the 21st century, we must steady our footing as a specialty on the 20th century's foundation so that we can wrestle with the more intricate challenges of the future. In the past two decades our global populations have experienced sectarian violence, wars, genocide, migration, terrorism, emerging infectious diseases, and pandemics. These natural and anthropogenic events will only worsen exponentially as we become intrinsically trapped by the effects of climate change. The United Nation's Intergovernmental Panel on Climate Change has recently concluded that regardless of how we try to reverse the effects of global warming, what we are experiencing now in terms of hurricanes, floods, and droughts will continue to worsen over the next 30 years. Should we, as a species, continue to equivocate and as global temperatures climb, these events will become more frequent and more catastrophic. "Catastrophic" may even be too mild a term. It is possible that over the next few years, the academic arm of emergency medicine may need to consider developing a curriculum devoted to "Cataclysmic Medicine." To confront these possibilities, there first needs to be a knowledge of disaster medicine and disaster management at its most basic level. It begins with crisis leadership, command and control, communications, and coordination. When all these pieces of the jigsaw puzzle are fitted together properly and enclosed by a proper ethical frame, then the best and most ethical and moral disaster medical can will be provided to the patient and to the community. The intent of this book is to introduce these concepts using diverse viewpoints and scenarios. Readers are challenged to cogitate, create, and layer their own set of building blocks upon the preexisting foundation, thereby reinforcing and sustaining their own capacity to prepare for and respond to any adverse eventuality, mass casualty or otherwise. I hope that the experiential and evidence- based contents of this book will inspire readers to delve deeper into the nuances of disaster medicine and will serve as an impetus for a more profound quest for knowledge and a desire to serve those who will be experiencing the worst moments of their lives. The intent of this book is to introduce these concepts using diverse viewpoints and scenarios. Readers are challenged to cogitate, create, and layer their own set of building blocks upon the preexisting foundation, thereby reinforcing and sustaining their own capacity to prepare for and respond to any adverse eventuality, mass casualty or otherwise. It is hoped that the experiential and evidence- based contents of this book will inspire readers to delve deeper into the nuances of disaster medicine and it will serve as an impetus for a more profound quest for knowledge and a desire to serve those who will be experiencing the worst moments of their lives.
In this book, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders.
For caregivers of deeply forgetful people: a book that combines new ethics guidelines with an innovative program on how to communicate and connect with people with Alzheimer's. How do we approach a "deeply forgetful" loved one so as to notice and affirm their continuing self-identity? For three decades, Stephen G. Post has worked around the world encouraging caregivers to become more aware of-and find renewed hope in-surprising expressions of selfhood despite the challenges of cognitive decline. In this book, Post offers new perspectives on the worth and dignity of people with Alzheimer's and related disorders despite the negative influence of "hypercognitive" values that place an ethically unacceptable emphasis on human dignity as based on linear rationality and strength of memory. This bias, Post argues, is responsible for the abusive exclusion of this population from our shared humanity. With vignettes and narratives, he argues for a deeper dignity grounded in consciousness, emotional presence, creativity, interdependence, music, and a self that is not "gone" but "differently abled." Post covers key practical topics such as: * understanding the experience of dementia * noticing subtle expressions of continuing selfhood, including "paradoxical lucidity" * perspectives on ethical quandaries from diagnosis to terminal care and everything in between, as gleaned from the voices of caregivers * how to communicate optimally and use language effectively * the value of art, poetry, symbols, personalized music, and nature in revealing self-identity * the value of trained "dementia companion" dogs At a time when medical advances to cure these conditions are still out of reach and the most recent drugs have shown limited effectiveness, Post argues that focusing discussion and resources on the relational dignity of these individuals and the respite needs of their caregivers is vital. Grounding ethics on the equal worth of all conscious human beings, he provides a cautionary perspective on preemptive assisted suicide based on cases that he has witnessed. He affirms vulnerability and interdependence as the core of the human condition and celebrates caregivers as advocates seeking social and economic justice in an American system where they and their loved ones receive only leftover scraps. Racially inclusive and grounded in diversity, Dignity for Deeply Forgetful People also includes a workshop appendix focused on communication and connection, "A Caregiver Resilience Program," by Rev. Dr. Jade C. Angelica.
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.
In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.
This is a unique and valuable work, which traces the experiences of over 100 parents who have lived through the loss of a baby. It follows them from pregnancy through to13 months after the death. Based on rigorous scientific research it describes their feelings when crucial decisions are made on behalf of their child, and examines their capacity to take responsibility for such decisions. By analysing those factors which help or hinder them, the book provides guidance to health professionals on how the services they offer may be improved. Neonatologists, paediatricians, midwives and neonatal nurses will find it an essential and enlightening read. Primary care clinicians, intensive care staff and hospital chaplains will discover insights which help them to support a wider group of patients and relatives.
In Ethical Dilemmas in Pediatrics, Forman and Ladd clarify, conceptualize, and guide reasoning toward defensible conclusions relating to ethical decisions in medicine. Brief and challenging clinical cases are followed by key discussion questions. The discussions introduce vocabulary, distinctions, concepts, and analysis designed to deepen understanding. Developed as a teaching tool, the book may be used for class discussions and case conferences. Deciding when not to treat, volunteering children for research, achieving the best doctor-patient relationship, and treating adolescents are among the major topics addressed. Originally published in 1991 by Springer-Verlag.
Law, Immunization and the Right to Die focuses on the urgent matter of legal appeals and judicial decisions on assisted death. Drawing on key cases from the United Kingdom and Canada, the book focuses on the problematic paternalism of legal decisions that currently deny assisted dying and questions why the law fails to recognize what many describe as "compassionate motives" for assisted death. When cases are analyzed as discourses that are part of a larger socio-political logic of governance, judicial decisions, it is argued here, reveal themselves as relying on the construction of neoliberal fictions - fictions that are here elucidated with reference to Michel Foucault's theoretical insights on pastoral power and Roberto Esposito's philosophical thesis on immunization. Challenging the socio-political logic of neoliberalism, the issue of assisted dying goes beyond the predominant legal concern with protecting - or immunizing - individuals from one another, in favor of minimal interference. This book calls for a new kind of politics: one that might affirm people and their finitude both more collectively, and more compassionately.
Sparking controversy in medical, social and professional circles, the nation's most respected medical ethicist strikes at the heart of America's growing health care crisis--the care of the aged. The New York Times Book Review calls Setting Limits "A pivotal work . . . the benchmark for future moral, medical and policy discussions of aging".
There has been a remarkable growth of interest in the ethical
dimension of economic affairs. Whilst the interest in business
ethics has been long-standing, it has been given renewed emphasis
by high profile scandals in the world of business and finance. At
the same time many economists, dissatisfied with the discipline's
emphasis on self-interest and individualism, and by the asocial
nature of much economic theory, have sought to enlarge the scope of
economics by looking at ethical questions. |
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