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.

Health promotion is an increasingly important part of the work of most health professionals. Yet health promotion is qualitatively different from traditional health care activities.

This book will be a focused introduction to, and exploration of, ethical issues in health promotion. It aims to provide a rationale for the underlying value of health promotion and for resolving value conflicts. To what extent should an individual be obliged to contribute to the collective health of a society? Should a society be more concerned to promote health than to treat existing disease and illness? Indeed can a society be said to have a responsibility for the health of its members?

The first part of the book addresses the theoretical context of ethics and health promotion. The second part focuses on examples relating to nursing and other health professionals, using a case study approach. The book will be invaluable in helping professionals understand and respond to ethical challenges in practical ways.

Do people have a moral right to sell their kidneys, or other body parts? Is it wrong to receive money for being a surrogate mother? Can we - and should we - patent DNA? How ethical is the 'commodification' of the human body?

Bodies for Sale: Ethics and Exploitation in the Human Body Trade explores the philosophical and practical issues raised by activities such as surrogacy and organ trafficking. Stephen Wilkinson asks what is it that makes some commercial uses of the body controversial, whether the arguments against commercial exploitation stand up, and whether legislation outlawing such practices is really justified.

In Part One Wilkinson explains and analyses some of the notoriously slippery concepts used in the body commodification debate, including exploitation, harm and consent. In Part Two he focuses on three controversial issues (the buying and selling of human kidneys, commercial surrogacy, and DNA patenting) outlining contemporary regulation and investigating both the moral issues and the arguments for legal prohibition.

Combining philosophical analysis with a detailed examination of current practice, Bodies for Sale is a comprehensive introduction to the ethics of body commodification and will be of interest to students of philosophy, politics and law as well as anyone with a serious interest in healthcare ethics and policy.

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.

What is illness? Is it a physiological dysfunction, a social label, or a way of experiencing the world? How do the physical, social, and emotional worlds of a person change when they become ill? Can there be well-being within illness? In this remarkable and thought-provoking book, Havi Carel explores these questions by weaving together the personal story of her own illness with insights and reflections drawn from her work as a philosopher. Carel's fresh approach to illness raises some uncomfortable questions about how we all - whether healthcare professionals or not - view the ill, challenging us to become more thoughtful. Illness unravels the tension between the universality of illness and its intensely private, often lonely, nature. It offers a new way of looking at a matter that affects every one of us. Revised and updated throughout, the third edition of this groundbreaking volume includes a new chapter on organ transplantation. Illness: The Cry of the Flesh will prove essential reading to those studying philosophy, medical ethics, and medical anthropology, as well as those in the healthcare and medical professions. It will also be of interest to individuals who live with illness, and their friends and families.

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

In the wake of the successful cloning of animals and the promises -- or fears -- of stem cell research, new discoveries in science and medicine need more than ever to be accompanied by careful moral reflection. Contending that concern over the ethical dimensions of these and other like issues are no longer just in the domain of those involved in medical practice, the third edition of "Ethics of Health Care" claims these are vital topics that should matter deeply to all citizens.

While stressing the Catholic tradition in health care ethics, "Ethics of Health Care" is ecumenical, incorporating a broader Christian tradition as well as humanistic approaches, and takes as common ground for mutual understanding the "Universal Declaration of Human Rights of the United Nations." This new third edition is a response to the many developments in theology and the startlingly rapid changes in the arenas of medicine and health care over the past decade, from the dominance of managed care to increased surgery on an "outpatient" basis; from hospice care for the dying to the increasing use of drugs in the treatment of mental illness.

Revised and thoroughly up-to-date, this third edition continues with its valuable teaching aids, including case studies, study questions, chapter summaries, a bibliography, and complete index.

The purpose of medical humanities is to improve the delivery of effective health care through a better understanding of disease - in society, and in the individual. The interfaces between the science of medicine and the arts, philosophy, sociology and law interpret causes and effects of disease. The field of medical ethics is the most prominent offspring of this wider debate, yet the context of disease in the life of the individual and of society is profound and far-reaching. The influences of medicine on the humanities and vice versa are all around, yet only recently have they been recognized in the wider world of health care.

Revolutionary advances in biomedical research and information systems technology pose new and difficult issues for American health care policy, especially in the context of managed care. Health Care Policy in an Age of New Technologies takes on this challenging array of issues, where the dignity of individual life meets the imperatives of the national-level health care system: the right to die, rationing of care, organ transplants, experiments with human embryos, genetic research, confidentiality of medical records, and other ethical dilemmas.

Chapters on a patient's bill of rights, and on medical education and physician training, link the book to policy issues of direct concern to the public and practitioners. Throughout the book, the authors place critical questions in their political, legal, social, economic, and ethical context. Each chapter ends with discussion points, and a multimedia bibliography directs readers to relevant films, documentaries, and case studies.

Revolutionary advances in biomedical research and information systems technology pose new and difficult issues for American health care policy, especially in the context of managed care. Health Care Policy in an Age of New Technologies takes on this challenging array of issues, where the dignity of individual life meets the imperatives of the national-level health care system: the right to die, rationing of care, organ transplants, experiments with human embryos, genetic research, confidentiality of medical records, and other ethical dilemmas.

Chapters on a patient's bill of rights, and on medical education and physician training, link the book to policy issues of direct concern to the public and practitioners. Throughout the book, the authors place critical questions in their political, legal, social, economic, and ethical context. Each chapter ends with discussion points, and a multimedia bibliography directs readers to relevant films, documentaries, and case studies.

As growing numbers of patients turn to complementary and alternative medicine (CAM), the focus of attention has largely been on whether these therapies work and whether they are safe. These questions are central to further integration of CAM with orthodox medicine. But in the absence of formal regulation, it is equally critical to consider the ethical dimensions of the CAM therapeutic encounter.
In this book, Julie Stone demonstrates that ethical issues are no less relevant to CAM therapists than they are to doctors or any other group of health professionals. She provides CAM therapists with a detailed framework of the specific ethical issues which affect CAM practice to help practitioners think constructively about how ethics underpin their therapeutic work.
An Ethical Framework for Complementary and Alternative Therapists encourages critical and reflective practice, suggests practical problems to common problems, includes illustrative scenarios of ethical dilemmas faced by therapists and summarises key points. This timely book offers a comprehensive guide to this important area. Its challenging conclusions are as relevant to experienced practitioners as to students and newly qualified therapists. This book will also interest policy makers and professional bodies interested in strengthening and enhancing CAM's potential.

As growing numbers of patients turn to complementary and alternative medicine (CAM), the focus of attention has largely been on whether these therapies work and whether they are safe. These questions are central to further integration of CAM with orthodox medicine. But in the absence of formal regulation, it is equally critical to consider the ethical dimensions of the CAM therapeutic encounter.
In this book, Julie Stone demonstrates that ethical issues are no less relevant to CAM therapists than they are to doctors or any other group of health professionals. She provides CAM therapists with a detailed framework of the specific ethical issues which affect CAM practice to help practitioners think constructively about how ethics underpin their therapeutic work.
An Ethical Framework for Complementary and Alternative Therapists encourages critical and reflective practice, suggests practical problems to common problems, includes illustrative scenarios of ethical dilemmas faced by therapists and summarises key points. This timely book offers a comprehensive guide to this important area. Its challenging conclusions are as relevant to experienced practitioners as to students and newly qualified therapists. This book will also interest policy makers and professional bodies interested in strengthening and enhancing CAM's potential.

This is the first textbook of surgical ethics. It is a practical, clinically comprehensive, well-organized guide to ethical issues in surgical practice, research, and educatio written by leading figures in surgery and bioethics. The authors cover the surgeon-patient relationship, the full range of surgical patients, surgical education and research and surgery and managed care. Their chapters are not abstract discussions of ethical principles; rather, they connect directly with the everyday concerns of practising surgeons.

Three decades after the first heart transplant surgery stunned the world, organs including eyes, lungs, livers, kidneys, and hearts are transplanted every day. But despite its increasingly routine nature-or perhaps because of it-transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch explores a variety of questions that continue to vex the transplantation community, offering his own solutions in many cases.

Ranging from the most fundamental questions to recently emerging issues, "Transplantation Ethics" is the first complete and systematic account of the ethical and policy controversies surrounding organ transplants. Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He lobbies for an allocation system-administered by nonphysicians-that considers both efficiency and equity, that takes into consideration the patient's age and previous transplant history, and that operates on a national rather than a regional level.

Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, social workers, members of organ procurement organizations, and government officials involved in the regulation of transplants.

Advances in genetic technology in general and medical genetics in particular will enable us to intervene in the process of human biological development which extends from zygotes and embryos to people. This will allow us to control to a great extent the identities and the length and quality of the lives of people who already exist, as well as those we bring into existence in the near and distant future. "Genes and Future People" explores two general philosophical questions, one metaphysical, the other moral: (1) How do genes, and different forms of genetic intervention (gene therapy, genetic enhancement, presymptomatic genetic testing of adults, genetic testing of preimplantation embryos), affect the identities of the people who already exist and those we bring into existence? and (2) How do these interventions benefit or harm the people we cause to exist in the near future and those who will exist in the distant future by satisfying or defeating their interest in having reasonably long and disease-free lives?"Genes and Future People" begins by explaining the connection between genes and disease, placing genetic within a framework of evolutionary biology. It then discusses such topics as how genes and genetic intervention influence personal identity, what genetic testing of individuals and the knowledge resulting from it entails about responsibility to others who may be at risk, as well as how gene therapy and genetic enhancement can affect the identities of people and benefit or harm them. Furthermore, it discusses various moral aspects of cloning human beings and body parts. Finally, it explores the metaphysical and moral implications of genetic manipulation of the mechanisms of aging to extend the human life span.The aim "Genes and Future People" is to move philosophers, bioethicists, and readers in general to reflect on the extent to which genes determine whether we are healthy or diseased, our identities as persons, the quality of our lives, and our moral obligations to future generations of people.

In this book Paul Carrick charts the ancient Greek and Roman foundations of Western medical ethics. Surveying 1500 years of pre-Christian medical moral history, Carrick applies insights from ancient medical ethics to developments in contemporary medicine such as advance directives, gene therapy, physician-assisted suicide, abortion, and surrogate motherhood. He discusses such timeless issues as the social status of the physician; attitudes toward dying and death; and the relationship of medicine to philosophy, religion, and popular morality. Opinions of a wide range of ancient thinkers are consulted, including physicians, poets, philosophers, and patients. He also explores the puzzling question of Hippocrates' identity, analyzing not only the Hippocratic Oath but also the Father of Medicine's lesser-known works.

Complete with chapter discussion questions, illustrations, a map, and appendices of ethical codes, "Medical Ethics in the Ancient World" will be useful in courses on the medical humanities, ancient philosophy, bioethics, comparative cultures, and the history of medicine. Accessible to both professionals and to those with little background in medical philosophy or ancient science, Carrick's book demonstrates that in the ancient world, as in our own postmodern age, physicians, philosophers, and patients embraced a diverse array of perspectives on the most fundamental questions of life and death.

Thirty years ago, English jurist Patrick Devlin wrote: "Is it not a pleasant tribute to the medical profession that by and large it has been able to manage its relations with its patients ... without the aid of lawyers and law makers."

Medical interventions at the beginnings and the endings of life have rendered that assessment dated if not defeated.

This book picks up some of the most important of those developments and reflects on the legal and social consequences of this metamorphosis over the past ten years, and will be of interest to students of law, sociology and ethics who want a considered and critical introduction to, and reflection on, key issues in these pivotal moments of human life.

Nursing staff of many specialities are taking on and developing their roles in new and advanced practice areas. Patients will be offered new services from highly skilled advanced nurse practitioners. Such nurses need guidance, direction and information to assist them in their new roles. This book will offer insight and guidance on a variety of issues that are likely to be encountered by the Nurse Practitioner in everyday practice. * *First book presenting ethical challenges at Nurse Practitioner level * * * Aims to guide practice and offer points for discussion and reflective thinking

Deckhead: An important examination of the theological, spiritual and ethical issues surrounding death.

What do faithful living and faithful dying mean as we near life's end? With all the technology and choices available to us today, making decisions about the end of life grows ever more difficult. As a result of all the theological and ethical issues that have arisen around the dying process in recent years, the 72nd General Convention of the Episcopal Church created a task force to study and report on these concerns. This is the report of the End-of-Life Task Force. In it, the Task Force responds to the broad range of theological, ethical, pastoral and policy issues that are generated by the need to provide loving and fitting care at the end of life.

Intended as a teaching document, Faithful Living, Faithful Dying will be useful as a discussion tool for the church, for individuals facing difficult decisions, for professionals, such as clergy and health care providers, and for those who make public policy.

From Harry and Louise through the McCaughey septuplets, this book explains stories and issues in health care ethics that have appeared in the news media. Written for the general reader in a pluralistic society, it outlines and applies principles of justice from the Catholic tradition to contemporary problems that increasingly affect us all.

This second edition contains extensive new material and new topics, including physician-assisted suicide, managed care, organ donation, genetic testing, cloning, and the question of futility. Aimed at a wide audience, this book will also be useful for introductory ethics courses in colleges and high schools.

Creative Ways to Learn Ethics is an accessible, easy-to-read guide that compiles a variety of ethics trainings to help professionals stimulate their minds, relieve stress, and increase engagement and memory retention. The book uses a range of experiential and thought-provoking approaches, including contemplative exercises, expressive arts, games, and media. Each chapter contains objectives, detailed procedures, adaptations for different audiences, and handouts. Trainers, educators, clinicians, and other mental health professionals can use these exercises in various settings and modify them to meet the needs of their clients.

The ability to reason ethically is an extraordinarily important aspect of professionalism in any field. Indeed, the greatest challenge in ethical professional practice involves resolving the conflict that arises when the professional is required to choose between two competing ethical principles. Ethical Reasoning in the Mental Health Professions explores how to develop the ability to reason ethically in difficult situations.

Other books merely present ethical and legal issues one at a time, along with case examples involving "right" and "wrong" answers. In dramatic contrast, Ethical Reasoning in the Mental Health Professions provides you with the needed background in methods of ethical reasoning and introduces an innovative nine-step model of ethical decision-making for resolving ethical dilemmas.

Ethical Reasoning in the Mental Health Profession discusses the ethical codes of both psychology and counseling. This interdisciplinary approach promotes a better understanding of the similarities and differences in the points of emphasis in the two codes, which, in turn, enriches your understanding of the range of ethical considerations relevant to the practice of the mental health professions.

Since the turn of the millennium, the potential for patients' knowledge to contribute to medical knowledge has been increasingly recognized by medical sociologists and anthropologists. Where previously such knowledge may have been written off as 'beliefs' and assumed to be inaccurate when it contradicted established medical science, it is increasingly recognized that patients-especially those with chronic conditions-can add a valuable perspective to the clinical knowledge of medical professionals. Sometimes this means working together to reassess treatment priorities, and at other times it may mean a patient-led movement to influence the direction of new research, based on patients' experiences. Ushiyama takes the case of eczema (atopic dermatitis)-a chronic condition with a history of patient-led controversy over treatment methods - as a case study in how patient knowledge has come to affect change in medical practice. Comparing ethnographic fieldwork from Japan and the UK, she builds a complex picture of the differences in approach to treatment in light of attitudes to patients' knowledge.

The question of how societies respond to our bodies' ills is one which has had trenendous hold on contemporary imaginations. This reader will include selections by the best thinkers in the ethics of health care, bioethics and philosophy of health care. Unlike the majority of collections that serve undergraduate and graduate courses in bioethics, the reader will stress a ider rabge of questions and invite enquiry that broadens the range of discourse.

Most available resources for teachers and students in biomedical ethics are based on a notion of medicine and of how to understand and illuminate its ethical problems that is at least two decades old. Meaning and Medicine dramatically expands the repertoire of resources for teachers and students of bioethics.
In addition to providing fresh perspectives on both traditional and emerging questions in bioethics, this Reader focuses on questions in social philosophy, epistemology, and metaphysics as they are raised by developments in contemporary health care.
A chief aim of this resource is to rekindle interest in seeing health care not solely as a set of practices so problematic as to require ethical analysis by philosophers and other scholars, but as a field whose scrutiny is richly rewarding for the traditional concerns of philosophy.