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.

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.

This fifth edition of Where Medicine Fails, like previous editions, argues for a broader definition of society's responsibilities to the ill than is commonly perceived to be the case. The authors examine the moral and economic implications of medical technology, especially in regard to fetal tissue transplant, cancer survival, childbirth, and dying, and provide a thoughtful assessment of the issues and challenges facing American hospitals. Seventeen chapters are new to this edition. The aim of this volume is to encourage serious examination of the current structure of health services and of the complicated facets of health care reform.

Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V. Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V. Campbell, who was the founding editor of the internationally renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues from various disciplines, including law and various branches of healthcare. The diversity of topics and depth of contributors' insights reflect the breadth and impact of Campbell's philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell's emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell's work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead.

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 Replacement Parts, internationally recognized bioethicist Arthur L. Caplan and coeditors James J. McCartney and Daniel P. Reid assemble seminal writings from medicine, philosophy, economics, and religion that address the ethical challenges raised by organ transplantation. Caplan's new lead essay explains the shortfalls of present policies. From there, book sections take an interdisciplinary approach to fundamental issues like the determination of death and the dead donor rule; the divisive case of using anencephalic infants as organ donors; the sale of cadaveric or live organs; possible strategies for increasing the number of available organs, including market solutions and the idea of presumed consent; and questions surrounding transplant tourism and "gaming the system" by using the media to gain access to organs. Timely and balanced, Replacement Parts is a first-of-its-kind collection aimed at surgeons, physicians, nurses, and other professionals involved in this essential lifesaving activity that is often fraught with ethical controversy.

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

In the last fifty years, average overall health status has increased more or less in parallel with a much celebrated decline in mortality, attributed mostly to poverty reduction, sanitation, nutrition, housing, immunization, and improved medical care. It is becoming increasingly clear, however, that these achievements were not equally distributed. In most countries, while some social groups have benefited significantly, the situation of others has stagnated or may even have worsened. If health is a prerequisite to a person functioning as an agent, inequalities in health constitute inequalities in people's capability to function - a denial of equality of opportunity. So why should a concern with health equity be singled out from the pursuit of social justice more generally? Can existing theories of justice provide an adequate account of health equity? And what ethical problems arise in evaluating health inequalities? These are some of the important questions that this book addresses in building an interdisciplinary understanding of health equity. With contributions from distinguished philosophers, anthropologists, economists, and public-health specialists, it centres on five major themes: what is health equity?; health equity and social justice; responsibilities for health; ethical issues in health evaluation; and anthropological perspectives.

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.

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".

Published in 1998, this book is a collected volume of papers from the first conference of the European Network for Biomedical ethics. The main subject of this conference is the ethical assessment of IVF in view of its concrete application as an infertility treatment and the consideration of possible alternatives for use. Twenty years after the introduction and the establishment of this therapy a more concrete evaluation of its medical indications, social conditions and consequences, the psychological consequences for the women involved and the parent-child relationship becomes possible. The legal and ethical evaluation of the reproduction technology as regards for example the legal and moral status of supernumery embyos in cryo-conservation has also to be considered in a European perspective. The ethical evaluation concentrates today on the new evolution that IVF technology takes in relation to the extension of diagnostics possibilities due to genetic research. Little work has been done on the connection between IVF and genetic diagnostics and therapy, so the medical and ethical evaluation of the connecting lines are also included in the book.

This book describes, in fascinating detail, a variety of experiments sponsored by the U.S. government in which people were exposed to radiation without their knowledge. After reviewing hundreds of thousands of documents from the Atomic Energy Commission and other agencies, the Advisory Committee appointed by President Clinton in January 1994 found that nearly 4,000 human radiation experiments--most involving very low doses of radioactive tracers--were sponsored by the federal government between 1944-1974. This book documents these findings to provide a fascinating if not disturbing reminder of both the shocking standards for human experimentation and the shrouded practice of government secrecy in recent history. Carried out at the height of the Cold War, experiments included feeding radioactive cereal to teenagers at a school for the mentally retarded, irradiating the testicles of prison inmates, injecting plutonium into hospital patients, and intentional releases of radiation into the environment. The book places these experiments within their historical context, and a review of the relevant government policies and ethics standards at the time is included. The analysis is then applied to contemporary research on human subjects. The book concludes with a discussion of the Committee's key findings and a set of recommendations for changes in in institutional review boards, the interpretation of ethics rules and policies, the conduct of research involving military personnel, the oversight and accountability for ethical violations, compensation for research injuries, and balancing national securities interests with the rights of the public. This compelling volume will prove to be a landmark in the development of standards for human experimentation. Ethicists, public health professionals and those interested in the history of medicine and Cold War history will be intrigued by the findings in this volume.

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.
In this volume a group of interdisciplinary scholars provide contributions which include evaluations of work in business ethics, empirical studies of such issues as social and ethical investing, the place of ethics in the new economics and perspectives from other disciplines.

This book examines major ethical issues in nursing practice. It eschews the abstract approaches of bioethics and medical ethics, and takes as its point of departure the difficulties nurses experience practising within the confines of a biomedical model and a hierarchical health care system. It breaks out of the rigid categories of mainstream health care ethics (autonomy, beneficence, quality of life, utilitarianism) and provides case studies, experiences and challenging lines of thought for the new professional nurse. The contributors examine the role of the nurse in relation to themes such as informed consent, privacy and dignity, and confidentiality. Nursing accountability is also considered in relation to the contemporary Western health care system as a whole. New and critical essays examine the nature of professional codes, care, medical judgement, nursing research and the law. Controversial issues, such as feeding those who cannot or will not eat, the epidemiology of HIV and dilemmas of choice and risk in the care of the elderly are tackled honestly and openly.

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

To understand the ethical issues raised by genetic counselling, it is necessary for the practitioner, the detached observer and the student to be aware of different perspectives. This work includes contributions from health professionals engaged in genetic counselling, and also from observers and critics of genetic counselling who have backgrounds in law, philosophy, biology, social science, and in advocacy on behalf of those with mental handicap. This diversity is designed to assist health professionals in examining their activities with a fresh eye; it may also help the observer-critic to understand the ethical problems that arise in genetic counselling practice. It is natural for health professionals to focus their concern on the immediate questions raised by individual clients, and for detached observers to consider the broader social implications of the subject.

To understand the ethical issues raised by genetic counselling, it is necessary for the practitioner, the detached observer and the student to be aware of different perspectives. This work includes contributions from health professionals engaged in genetic counselling, and also from observers and critics of genetic counselling who have backgrounds in law, philosophy, biology, social science, and in advocacy on behalf of those with mental handicap. This diversity is designed to assist health professionals in examining their activities with a fresh eye; it may also help the observer-critic to understand the ethical problems that arise in genetic counselling practice. It is natural for health professionals to focus their concern on the immediate questions raised by individual clients, and for detached observers to consider the broader social implications of the subject.

Questions about the dignity of the human person give rise to many of the most central and hotly disputed topics in bioethics. In A Defense of Dignity: Creating Life, Destroying Life, and Protecting the Rights of Conscience, Christopher Kaczor investigates whether each human being has intrinsic dignity and whether the very concept of "dignity" has a useful place in contemporary ethical debates. Kaczor explores a broad range of issues addressed in contemporary bioethics, including whether there is a duty of "procreative beneficence," the ethics of ectopic pregnancy, and the possibility of "rescuing" human embryos with human wombs or artificial wombs. A Defense of Dignity also treats issues relevant to the end of life, including physician-assisted suicide, provision of food and water to patients in a persistent vegetative state, and how to proceed with organ donation following death. Finally, what are the duties and prerogatives of health care professionals who refuse in conscience to take part in activities that they regard as degrading to human dignity? Should they be forced to do what they consider to be violations of the patient's well being, or does patient autonomy always trump the conscience of a health care professional? Grounded in the Catholic intellectual and moral tradition, A Defense of Dignity argues that all human beings from the beginning to the end of their lives should be treated with respect and considers how this belief should be applied in controversial cases.

Enter the world of organ transplantation and develop a new understanding of processes and techniques for working effectively with patients in this increasing medical population. This multidisciplinary overview of organ transplantation contains chapters by major figures in the medical arena, internationally known bioethics writers, and experienced chaplains from the clinical setting of transplantation, as well as respected pastoral theologians. The authors, who include Art Caplan, Donald Capps, and Jack Copeland, explain transplantation completely for the nonmedical person and delve into the myriad ethical and religious issues and controversies surrounding organ donation and transplantation. Enlightening chapters clarify issues and help readers better understand the transplantation process, making them more effective in their work with transplant patients. Organ Transplantation in Religious, Ethical and Social Context is divided into three sections. The first emphasizes transplantation as a team effort. Chapters focus on the various roles of chaplains and other team members.Section two addresses ethical questions which arise from transplantation and organ donation and includes interfaith perspectives. The third section is dedicated to theological and pastoral views concerning transplantation. Some specific topics discussed in this book include: a surgeon's perspective of the role of the chaplain influence of psychosocial factors in the heart transplantation decision process ministry to organ recipients and their families the special relationship between the transplant coordinator and the transplant patient Catholic and interfaith perspectives on organ donation using the Psalms as a pastoral resource with transplant patients Hospital chaplains, transplant social workers, transplant coordinators, and other professionals interested or involved in the process of organ transplantation will find this book to be full of interesting and thought-provoking insights and information.

Law, Palliative Care and Dying critically examines the role of the legal framework in shaping the boundaries of palliative care practice. The work underlines the importance of a distinct legal framework for specialist palliative care which can provide clarity for both the healthcare professional and the patient. It examines the legal and ethical justifications for specialist palliative care practices and, in doing so, it questions the legitimacy of the distinction between euthanasia and practices such as palliative sedation. Moreover, this work discusses the influence of a human rights discourse on palliative care and examines the contribution of autonomy, dignity, and the right to palliative care. This book includes detailed comparative research on several European jurisdictions. The jurisdictions illustrate varied approaches to palliative care regulation and promotion. In this manner, the role of professional guidelines and legislation are drawn out and common themes in the regulation of palliative care emerge.

This collection of essays, with an extended commentary by the editor, is concerned with developments in reproductive technology and the possibilities of genetic engineering. The volume provides a forum for debate between science and society. Leading scientists in the field explain the nature and goals of "test tube" reproduction and genetic engineering, and their eugenic implications. Other papers draw out the legal and ethical problems raised by these developments. The ethical dilemmas are discussed both from the point of view of secular moral philosophy and from a theological perspective. The extended commentary attempts to place these questions in the context of a social ethic, rather than an individualist one, in contrast to the approach adopted by the Warnock Report.

In his famous seminar on ethics, Jacques Lacan uses this question as his departure point for a re-examination of Freud's work and the experience of psychoanalysis in relation to ethics. Delving into the psychoanalyst's inevitable involvement with ethical questions, Lacan clarifies many of his key concepts. During the seminar he discusses the problem of sublimation, the paradox of jouissance, the essence of tragedy, and the tragic dimension of analytical experience. One of the most influential French intellectuals of this century, Lacan is seen here at the height of his powers.

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.

Paternalistic intervention, especially in the context of modern medicine and health care, is the issue of this monograph, which aims to define and morally assess paternalistic interventions through a defined conceptual background. The method employed for this purpose is that of applied philosophical ethics in the analytic tradition. It is argued that there is a marked distinction between strong and weak paternalism. Strong paternalism is defined as the violation of the autonomy of a patient, when that person is capable of autonomous decision-making. Weak paternalism is the violation of autonomy when a person is temporarily incapable of self-determined decision-making.

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.