Where should physicians get their ethics? Professional codes such as the Hippocratic Oath claim moral authority for those in a particular field, yet according to medical ethicist Robert Veatch, these codes have little or nothing to do with how members of a guild should understand morality or make ethical decisions. While the Hippocratic Oath continues to be cited by a wide array of professional associations, scholars, and medical students, Veatch contends that the pledge is such an offensive code of ethics that it should be summarily excised from the profession. What, then, should serve as a basis for medical morality? Building on his recent contribution to the prestigious Gifford Lectures, Veatch challenges the presumption that professional groups have the authority to declare codes of ethics for their members. To the contrary, he contends that role-specific duties must be derived from ethical norms having their foundations outside the profession, in religious and secular convictions. Further, these ethical norms must be comprehensible to lay people and patients. Veatch argues that there are some moral norms shared by most human beings that reflect a common morality, and ultimately it is these generally agreed-upon religious and secular ways of knowing - thus far best exemplified by the 2005 Universal Declaration on Bioethics and Human Rights - that should underpin the morality of all patient-professional relations in the field of medicine. "Hippocratic, Religious, and Secular Medical Ethics" is the magnum opus of one of the most distinguished medical ethicists of his generation.

This volume collects essays by the late bioethicist John D. Arras, best known for his many contributions to the methodology of bioethics. Always open-minded, Arras did not favor a single theory or view of method in bioethics, eschewing labels such as "casuist" or "pragmatist." He was conversant with the main philosophical methods that have dominated bioethics since the field's origin, including principlism, Gert's common morality, the "new casuistry", pragmatism, and others. Rather than defending any particular theory or method, though, Arras rigorously investigated those methods - and how they both expand and limit our field of vision. He sought, in the tradition of Kierkegaard, to make life "harder" for bioethics, by uncovering challenges to the field's analytical methods. His favorite mode of exploration and expression was the thoughtful essay. The essays collected here reveal him thinking through new problems and new possibilities, and they invariably yield fresh and valuable insights.

The distinguished contributors to Confidentiality probe the ethical, legal, and clinical implications of a deceptively simple proposition: Psychoanalytic treatment requires a confidential relationship between analyst and analysand. But how, they ask, should we understand confidentiality in a psychoanalytically meaningful way? Is confidentiality a therapeutic requisite of psychoanalysis, an ethical precept independent of psychoanalytic principles, or simply a legal accommodation with the powers that be?
In wrestling with these questions, the contributors to Confidentiality are responding to a professional, ethical, and political crisis in the field of mental health. Psychotherapy - especially long-term psychotherapy in its psychoanalytic variants - has been undermined by an erosion of personal privacy that has become part of our cultural zeitgeist. The heightened demand for public transparency has forced caregivers from all walks of professional life to submit to increasing bureaucratic regulation.
For the contributors to this collection, the need for confidentiality is centrally involved in the relationship of the psychotherapeutic professions both to society and to the law. No less importantly, the requirement of confidentiality brings a clarifying perspective to debates within the psychotherapeutic literature about the relationship of theory to practice. It thereby provides a framework for shaping a set of ethical principles specifically adapted to the psychotherapeutic, and especially to the psychoanalytic, relationship.
Linking general issues of privacy to the intimate details of psychotherapeutic encounter, Confidentiality will serve as a basic guide to a wide range of professionals, including lawyers, social scientists, philosophers, and, of course, psychotherapists. Therapy patients, policy makers, and the wider public will also find it instructive to know more about the special protected conditions under which one can better come to "know thyself."

Public Bioethics collects the most influential essays and articles of James F. Childress, a leading figure in the field of contemporary bioethics. These essays, including new, previously-unpublished material, cohere around the idea of 'public bioethics,' which concerns the analysis and assessment of public policies in biomedicine, health care, and public health. The volume is divided into four sections - The first examines the principle of respect for autonomy and paternalistic policies and practices. The second explores the tension between bioethics, public policy, and religious convictions, such as the right of health care providers to conscientiously refuse to provide treatment to certain patients. The third section looks at practices and policiies related to organ transplantation; Childress places particular focus on determining death, obtaining first-person consent for deceased organ donation, fairly allocating donated organs, and related issues in the distribution of scarce resources. The final section maps the broad terrain of public ethics; Childress propoposes a triage framework for the use of resources in public health crises, addresses public health interventions that potentially infringe civil liberties, and sheds light on John Stuart Mill's misunderstood legacy on public health ethics. Public Bioethics deftly explicates both contemporary bioethical issues and the processes involved in determining appropriate policies and publicly justifying collective recommendations, reflecting the author's vast experience serving on public bioethics committees, particularly at the national level in the United States. Providing a thorough account of the principles that govern issues within the healthcare system, this book will appeal to bioethicists, physicians, and public policy-makers.

The neurological criteria for the determination of death remain controversial within secular and Catholic circles, even though they are widely accepted within the medical community. In Determining Death by Neurological Criteria, Matthew Hanley offers both a practical and a philosophical defense. Hanley shows that the criteria are often misapplied in clinical settings, leading to cases where persons declared dead apparently spontaneously revive. These instances are often connected to a rushed decision to retrieve donated organs, thus undermining the trust of the public in organ donation. Hanley calls on health care institutions to take seriously their obligation to establish strict protocols for the determination of death, including who may conduct the examinations. From a broader perspective, Hanley considers how the criteria rely on a philosophical conception of the person as a living organism whose unity disintegrates at death. This view, he notes, corresponds to the Catholic conviction that the soul is the life-principle of the body, which departs at death, bringing about the destruction of the body-soul composite. The Vatican, recognizing that death is a medical judgment, has generally given its approval to the criteria. Hanley also reviews the many and various objections offered by detractors, including against the use of the apnea test, which is faulted as a practice that sometimes hastens death. The problem of the continued presence of certain vital functions within the deceased body of the brain dead is explored in detail, with reference to particular cases and to solutions proposed by leading physicians and bioethicists. Hanley likewise addresses the dilemma of having two separate standards for death, one neurological and the other cardiopulmonary. Given the possibility of resuscitation following loss of the cardio-circulatory system, he concludes that the neurological criteria must be the true standard. Stoppage of the heart leads swiftly to the final necrosis of the brain.

For the average person, genetic testing has two very different faces. The rise of genetic testing is often promoted as the democratization of genetics by enabling individuals to gain insights into their unique makeup. At the same time, many have raised concerns that genetic testing and sequencing reveal intensely personal and private information. As these technologies become increasingly available as consumer products, the ethical, legal, and regulatory challenges presented by genomics are ever looming. Assembling multidisciplinary experts, this volume evaluates the different models used to deliver consumer genetics and considers a number of key questions: How should we mediate privacy and other ethical concerns around genetic databases? Does aggregating data from genetic testing turn people into products by commercializing their data? How might this data reduce or exacerbate existing healthcare disparities? Contributing authors also provide guidance on protecting consumer privacy and safety while promoting innovation.

Whilst advances in reproductive medicine have enabled thousands of couples worldwide to have children, they also raise a plethora of ethical, philosophical and legal questions. This collection of essays by leading international scholars in bioethics, law, philosophy and public health, addresses many of the most difficult and intriguing issues. These include: the nature and scope of the right to reproduce, the meaning of parenthood and family, the significance of genetic connection to parenting, non-traditional families, sperm and egg donation, commercial surrogacy, prenatal genetic testing, reproductive cloning, obligations to children of reproductive technology and post mortem insemination. Legal and Ethical Issues in Human Reproduction is an important contribution to the growing literature on reproductive technology and one that will be of value to scholars, practitioners and students alike.

Addressing global health is one of the largest challenges facing humanity in the 21st century, however, this task is becoming even more formidable with the accelerated destruction of the planet. Building on the success of the previous edition, the book outlines how progress towards improving global health relies on understanding its core social, economic, political, environmental and ideological aspects. A multi-disciplinary group of authors suggest not only theoretically compelling arguments for what we must do, but also provide practical recommendations as to how we can promote global health despite contemporary constraints. The importance of cross-cultural dialogue and utilisation of ethical tools in tackling global health problems is emphasised. Thoroughly updated, new or expanded topics include: mass displacement of people; novel threats, including new infectious diseases; global justice; and ecological ethics and planetary sustainability. Offering a diverse range of perspectives, this volume is essential for bioethicists, public health practitioners and philosophers.

All persons, while different from one another, have the same value: this is the author's relatively uncontroversial starting point. Her end point is not uncontroversial: an ideal of justice as human flourishing, based on each person's unique set of capabilities. Because the book's focus is women's health care, gender justice, a necessary component of justice, is central to examination of the issues. Classical pragmatists and feminist standpoint theorists are enlisted in support of a strategy by which gender justice is promoted. Two features of the book are unique: (1) the topics presented cover the entire life span of women, not just those related to reproduction; (2) a range views about moral status are applied not only to fetuses but also to individuals already born. Attention to these features is intended to facilitate ethical consistency or moral integrity and respect for those who hold different moral views. While delineating and defending the book's perspective, the first section provides an overview of bioethics, critiques prevalent approaches to bioethics and models of the physician-patient relationship, and sketches distinguishing aspects of women's health care that are prevalently neglected. Positions about moral status are also presented. The second section identifies topics that are indirectly as well as directly related to women's health, such as domestic violence and caregiving. Brief cases illustrate variables relevant to each topic. Empirical and theoretical considerations follow each set of cases; these are intended to precipitate more expansive and critical examination of the issues raised. The last section is devoted to an egalitarian ideal that may be pursued throughan ethic of virtue or supererogation rather than obligation. By embracing this ideal, according to the author, moral agents support a more demanding level of morality than guidelines or laws require.

As prenatal tests proliferate, the medical and broader communities perceive that such testing is a logical extension of good prenatal care -- it helps parents have healthy babies. But prenatal tests have been criticized by the disability rights community, which contends that advances in science should be directed at improving their lives, not preventing them. Used primarily to decide to abort a fetus that would have been born with mental or physical impairments, prenatal tests arguably reinforce discrimination against and misconceptions about people with disabilities.

In these essays, people on both sides of the issue engage in an honest and occasionally painful debate about prenatal testing and selective abortion. The contributors include both people who live with and people who theorize about disabilities, scholars from the social sciences and humanities, medical geneticists, genetic counselors, physicians, and lawyers. Although the essayists don't arrive at a consensus over the disability community's objections to prenatal testing and its consequences, they do offer recommendations for ameliorating some of the problems associated with the practice.

Over the past decades, public trust in medical professionals has steadily declined. This decline of trust and its replacement by ever tighter regulations is increasingly frustrating physicians. However, most discussions of trust are either abstract philosophical discussions or social science investigations not easily accessible to clinicians. The authors, one a surgeon-turned-philosopher, the other an analytical philosopher working in medical ethics, joined their expertise to write a book which straddles the gap between the practical and theoretical. Using an approach grounded in the methods of conceptual analysis found in analytical philosophy which also draws from approaches to medical diagnosis, the authors have conceived an internally coherent and comprehensive definition of trust to help elucidate the concept and explain its decline in the medical context. This book should appeal to all interested in the ongoing debate about the decline of trust - be it as medical professionals, medical ethicists, medical lawyers, or philosophers.

Respect for autonomy has become a fundamental principle in human research ethics. Nonetheless, this principle and the associated process of obtaining informed consent do have limitations. This can lead to some groups, many of them vulnerable, being left understudied. This book considers these limitations and contributes through legal and philosophical analyses to the search for viable approaches to human research ethics. It explores the limitations of respect for autonomy and informed consent both in law and through the examination of cases where autonomy is lacking (infants), diminished (addicts), and compromised (low socio-economic status). It examines alternative and complementary concepts to overcome the limits of respect for autonomy, including beneficence, dignity, virtue, solidarity, non-exploitation, vulnerability and self-ownership. It takes seriously the importance of human relationality and community in qualifying, tempering and complementing autonomy to achieve the ultimate end of human research - the good of humankind.

Truth, Trust and Medicine investigates trust and honesty in medicine. It looks at the doctor-patient relationship, raising questions which disturb notions of patients' autonomy and self-determination, such as withholding information and consent and covert surveillance in care units. It will be of interest to those working in medical ethics and applied philosophy, and a valuable resource for practitioners of medicine.

History will mark the twenty-first century as the dawn of the age of precise genetic manipulation. Breakthroughs in genome editing are poised to enable humankind to fundamentally transform life on Earth. Those familiar with genome editing understand its potential to revolutionize civilization in ways that surpass the impact of the discovery of electricity and the development of gunpowder, the atomic bomb, or the Internet. Significant questions regarding how society should promote or hinder genome editing loom large in the horizon. And it is up to humans to decide the fate of this powerful technology. Rewriting Nature is a compelling, thought-provoking interdisciplinary exploration of the law, science, and policy of genome editing. The book guides readers through complex legal, scientific, ethical, political, economic, and social issues concerning this emerging technology, and challenges the conventional false dichotomy often associated with science and law, which contributes to a growing divide between both fields.

History will mark the twenty-first century as the dawn of the age of precise genetic manipulation. Breakthroughs in genome editing are poised to enable humankind to fundamentally transform life on Earth. Those familiar with genome editing understand its potential to revolutionize civilization in ways that surpass the impact of the discovery of electricity and the development of gunpowder, the atomic bomb, or the Internet. Significant questions regarding how society should promote or hinder genome editing loom large in the horizon. And it is up to humans to decide the fate of this powerful technology. Rewriting Nature is a compelling, thought-provoking interdisciplinary exploration of the law, science, and policy of genome editing. The book guides readers through complex legal, scientific, ethical, political, economic, and social issues concerning this emerging technology, and challenges the conventional false dichotomy often associated with science and law, which contributes to a growing divide between both fields.

This is an attempt to address the ethical issues raised by mental illness and its treatment by focusing on the question of autonomy. The mentally ill may be regarded as non-autonomous by virtue of irrationality, which may result in treatment models which may deny them a voice. As a counter to this, some have moved to the other extreme and argued that the mentally ill must be regarded as fully autonomous in all circumstances, and consequently that all their wishes regarding treatment must be respected. This book examines the ethical consequences of such simplistic approaches approaches towards autonomy and mental illness, and considers the ethical issues raised by specific forms of treatment. It is suggested in conclusion that improvement in the care and treatment of the mentally ill requires not only a fundamental change in social attitudes but also less impoverished conception of autonomy than some of those currently employed.

Winner of the NCTE George Orwell Award for Distinguished Contribution to Honesty and Clarity in Public Language Although Roe v. Wade identified abortion as a constitutional right 45 years ago, it still bears stigma-a proverbial scarlet A. Millions of Americans have participated in or benefited from an abortion, but few want to reveal that they have done so. Approximately one in five pregnancies in the US ends in abortion. Why is something so common, which has been legal so long, still a source of shame and secrecy? Why is it so regularly debated by politicians, and so seldom divulged from friend to friend? This book explores the personal stigma that prevents many from sharing their abortion experiences with friends and family in private conversation, and the structural stigma that keeps it that way. In public discussion, both proponents and opponents of abortion's legality tend to focus on extraordinary cases. This tendency keeps the national debate polarized and contentious, and keeps our focus on the cases that occur the least. Professor Katie Watson focuses instead on the cases that happen the most, which she calls "ordinary abortion." Scarlet A gives the reflective reader a more accurate impression of what the majority of American abortion practice really looks like. It explains how our silence around private experience has distorted public opinion, and how including both ordinary abortion and abortion ethics could make our public exchanges more fruitful. In Scarlet A, Watson wisely and respectfully navigates one of the most divisive topics in contemporary life. This book explains the law of abortion, challenges the toxic politics that make it a public football and private secret, offers tools for more productive private exchanges, and leads the way to a more robust public discussion of abortion ethics. Scarlet A combines storytelling and statistics to bring the story of ordinary abortion out of the shadows, painting a rich, rarely seen picture of how patients and doctors currently think and act, and ultimately inviting readers to tell their own stories and draw their own conclusions.

We live at a time when the human lifespan has increased like never before. As average lifespans stretch to new lengths, what impact should this have on our values? Should our values change over the course of our ever-increasing lifespans? Nancy S. Jecker coins the term, the life stage relativity of values, to capture the idea that at different stages of our lives, different ethical concerns shift to the foreground. During early life, infants and small children hold dear the value of being cared for and nurtured by someone they trust-and their vulnerability and dependency make these the right values for them. By early adulthood and continuing into midlife, the capacity for greater physical and emotional independence gives people reason to place more emphasis on autonomy and the ability to freely choose and carry out their plan of life. During old age, heightened risk for chronic disease and disability gives us a reason to shift our focus again, emphasizing safeguarding our central capabilities and keeping our dignity and self-respect intact. Despite different values becoming central at different stages of life, we often assume the standpoint of someone in midlife, who is in the midst of planning a future adulthood that stretches out before them. Jecker coins the term, midlife bias, to refer to the privileging of midlife. Midlife bias occurs when we assume that autonomy should be our central aim at all life stages and give it priority in a wide range of ethical decisions. The privileging of midlife raises fundamental problems of fairness. It also suggests the possibility of large gaps in the ethical principles and theories at hand. Ending Midlife Bias: New Values for Old Age addresses these concerns in a step-wise fashion, focusing on later life. Jecker first introduces a philosophical framework that extends moral theorizing to older adults, addressing midlife bias, the life stage relativity of values, human capabilities and dignity, time's passage, the narrative self, and justice between old and young. She then turns to policy and practice and explores ethical issues in bioethics, long term care, personal robotic assistants, care of the dying and newly dead, ageism in medical research, the allocation of healthcare, mandatory retirement, and the future of population aging.

Life and health sciences and biomedical studies have developed rapidly over the last few decades raising previously unanticipated ethical concerns and questions. New and emerging technologies require novel approaches, protocols and raised awareness to ensure adequate levels of biosecurity and biosafety as well as the implementation of special measures to prevent their potential misuse or dual use. This volume brings together an international collection of prominent ethics experts in health and life sciences, with the aim of providing clear and comprehensive guidelines for the establishment of efficient ethical strategies related to current and emerging biotechnologies and health research. Important current topics in research ethics including CRISPR-Cas9 technologies, gene editing, 'big data' in healthcare and life sciences, nutrition in medicine among other topics have found their place in this volume. In addition, the volume discusses the prospects for the implementation of an international unification of ethical standards in life sciences.

How is the concept of patient care adapting in response to rapid changes in healthcare delivery and advances in medical technology? How are questions of ethical responsibility and social diversity shaping the definitions of healthcare?
In this topical study, scholars in anthropology, nursing theory, law and ethics explore questions involving the changing relationship between patient care and medical ethics. Contributors address issues that challenge the boundaries of patient care, such as:
- HIV-related care and research
- the impact of new reproductive technologies
- preventative healthcare
- technological breakthroughs that are changing personal-caring relationships.
Chapters range from a consideration of the practicalities of nursing and family healthcare to a debate about 'universal human needs' and patients' rights.
This book is a provocative exploration of the ways in which healthcare models are socially constructed. It will be of interest to policy-makers, medical practitioners and administrators, as well as students of sociology, anthropology and social policy.

Ethics and Values in Psychotherapy is an examination of the role of the therapist as ethicist and the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. As Psychotherapy strives to establish itself as a 'Profession', practitioners are increasinly focusing on the issue of ethics as they attempt to agree on guidelines and standards for professional practice. Alan Tjeltveit argues that any discussion of professional and ethical practice in psychotherapy is inadequate if carried out in ignorance of or in isolation from traditional ethical theories. He applies this approach to issues such as: * the role of therapy in society * the goals and outcomes of psychotherapy * techniques and practices * the existence and operation of values * the intellectual and social context in which therapy takes place. In the second part of the book, he uses clinical examples and case studies to relate this theoretical discussion to clinical practice. Ethics and Values in Psychotherapy will be welcomed by the growing number of experienced Psychotherapists and post-graduate students who are interested in the increasingly contentious issue of professional ethics.

Series Information:
Professional Ethics

This volume covers a wide range of topics concerning methodological, epistemological, and regulatory-ethical issues around pharmacology. The book focuses in particular on the diverse sources of uncertainty, the different kinds of uncertainty that there are, and the diverse ways in which these uncertainties are (or could be) addressed. Compared with the more basic sciences, such as chemistry or biology, pharmacology works across diverse observable levels of reality: although the first step in the causal chain leading to the therapeutic outcome takes place at the biochemical level, the end-effect is a clinically observable result-which is influenced not only by biological actions, but also psychological and social phenomena. Issues of causality and evidence must be treated with these specific aspects in mind. In covering these issues, the book opens up a common domain of investigation which intersects the deeply intertwined dimensions of pharmacological research, pharmaceutical regulation and the related economic environment. The book is a collective endeavour with in-depth contributions from experts in pharmacology, philosophy of medicine, statistics, scientific methodology, formal and social epistemology, working in constant dialogue across disciplinary boundaries.

Few would question the necessity of artificial limbs for amputees. But what of surgery to lengthen the legs of children who are merely shorter than average? Hardly anyone would challenge the decision to prescribe Aricept to people with dementia. But is it acceptable to give the same medication to airline pilots seeking sharper mental focus on long-haul flights?

Humans have engaged in biological self-improvement since long before recorded history, from the impotence-curing wild lotus brew of the ancient Egyptians to the herbal energy drink favored by early Olympians. Now biomedical enhancements are pushing the boundaries of possibility and acceptability. Where do we draw the line? How do we know the true ramifications of pioneering medicine? What price are we willing to pay for perfection?

Maxwell J. Mehlman's provocative examination of these issues speaks to fundamental questions of what it means to be human. He finds public officials ill-equipped to handle the ethical, scientific, and public policy quandaries of biomedical enhancement. Instead of engaging difficult questions of morality, access, fairness, and freedom, elected officials have crafted toothless and counterproductive laws and regulations.

Mehlman outlines policy options to boost the societal benefits and minimize the risks from these technologies. In the process, he urges the public to face the ethical issues surrounding biomedical enhancement, lest our quest for perfection compromise our very humanity.

The financial burden and the level of specialized care required to look after older adults with dementia has reached the point of a public health crisis. Older adults diagnosed and living with the disorder reached 35.6 million worldwide in 2010 and is expected to increase to 135.5 million in 2050, with costs soaring to $1.1 trillion. In the face of the increasing burden this disorder poses to health care systems and the management of this patient population, intelligent assistive technologies (IATs) represent a remarkable and promising strategy to meet the need of persons suffering from dementia. These technologies aim at helping individuals compensate for specific physical and cognitive deficits, and maintain a higher level of independence at home and in everyday activities. However, the rapid development and widespread implementation of these technologies are not without associated challenges at multiple levels. An international and multidisciplinary group of authors provide future-oriented and in-depth analysis of IATs. Part I delineates the current landscape of intelligent assistive technologies for dementia care and age-related disability from a global perspective, while the contributions in Part II analyze and address the major psycho-social implications linked to the development and clinical use of IATs. In the last section, essays examine the major ethical, social and regulatory issues associated with the use of IATs in dementia care. This volume provides an authoritative and comprehensive overview of how IATs are reshaping dementia care.