This outstanding book is an update on where the mental health profession's complaints system is now. Its timely analysis follows in the wake of prior work on reform, which include the attempt in 2001 at the House of Lords to statutorily regulate psychotherapists in the UK. (Alderdice/Casement et al.) -- Professor Ann Casement, LP, Past-Chair UKCP. The patient's word was once easily dismissed against the word of the psychiatrist, doctor or therapist, leaving the patient vulnerable. Recognising this inherent risk in the relationship between clinicians and patients, professional regulations have gradually been established to facilitate patients' access to information, support and recourse. However, while most professions also explicitly protect their own members, there are, notably, no systems in place to protect psychotherapists. The current complaint procedure presumes the therapist's guilt until proven innocent, rather than the reverse. The Psychotherapist and the Professional Complaint explores this problem with sensitivity and rigour. In these chapters, the contributors examine ways to address serious conflicts in the psychotherapy relationship and the role of professional bodies in protecting their members while regulating their performance. Acknowledging both strengths and flaws, they outline the historical context and future prospects of the current complaint procedures. This book invites us to think and speak on the controversial subject of complaints, supporting patients, therapists and policymakers alike.

Strategies or decisions aimed at affecting, in a manner considered to be positive, the genetic heritage of a child in the context of human reproduction are increasingly being accepted in contemporary society. As a result, unnerving similarities between earlier selection ideology so central to the discredited eugenic regimes of the 20th century and those now on offer suggest that a new era of eugenics has dawned. The time is ripe, therefore, for considering and evaluating from an ethical perspective both current and future selection practices. This inter-disciplinary volume blends research from embryology, genetics, philosophy, sociology, psychology, and history. In so doing, it constructs a thorough picture of the procedures emerging from today's reproductive developments, including a rigorous ethical argumentation concerning the possible advantages and risks related to the new eugenics.

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."

Patient autonomy is an important concept in the clinical context, but the idea in contemporary bioethics discussions is often muddled. By looking closely at the ideas of Rosseau, Kant, and Mill, Autonomy and Patients' Decisions traces the modern concept of autonomy from its historical roots. Charting the changes in notions of autonomy in Beauchamp and Childress's seminal Principles of Biomedical Ethics to provide an overview of how autonomy has been viewed in the field, Merle Spriggs then identifies the four distinct notions of autonomy being referred to in contemporary discussion. The examination of these notions, especially the "descriptive psychological" account, in relation to case studies provides a clear concept of autonomy, compatible with both consequentialist and rights-based theories of ethics. This book provides a clear understanding of patient autonomy and will prove essential reading for health care professionals, bioethicsts, and philosophers.

The essays in this volume pay tribute to the achievements of Renee C. Fox in the fields of medicine and sociology. Many of the contributors are Fox's colleagues and current and former students from medicine, sociology, nursing, and bioethics. The title -- Society and Medicine -- reflects the leitmotif in Fox's work: her studies of and teaching about the nature of medicine and medical research; the training and work of their practitioners; the interrelationships between medicine and the societies and cultures of which it is a part; and, above all, the moral and spiritual dimensions of the healing arts. The essays reflect the influence of her scholarship and teaching upon their authors, each of whom is a colleague or has studied with her, but this book is not a "festschrift" in the conventional sense. That is, although the essays recognize, and in many cases pay tribute to, her work, Society and Medicine is not a collection about the corpus of Renee Fox's writings and their influence. Rather, the topics addressed are connected, in various ways, to themes Fox has explored over the years in her own journeys in to the field, or the journeys she has inspired others to make.

Each year, tens of thousands of children are conceived with donated gametes (sperm or eggs). By some estimates, there are over one million donor-conceived people in the United States and, of course, many more the world over. Some know they are donor-conceived. Some do not. Some know the identity of their donors. Others never will. Questions about what donor-conceived people should know about their genetic progenitors are hugely significant for literally millions of people, including donor-conceived people, their parents, and donors. But the practice of gamete donation also provides a vivid occasion for thinking about questions that matter to everyone. What is the value of knowing who your genetic progenitors are? How are our identities bound up with knowing where we come from? What obligations do parents have to their children? And what makes someone a parent in the first place? In Conceiving People: Identity, Genetics and Gamete Donation, Daniel Groll argues that people who plan to create a child with donated gametes should choose a donor whose identity will be made available to the resulting child. This is not, Groll argues, because having genetic knowledge is fundamentally important. Rather, it is because donor-conceived people are likely to develop a significant interest in having genetic knowledge and parents must help satisfy their children's significant interests. In other words, because a donor-conceived person is likely to care about having genetic knowledge, their parents should care too.

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.

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.

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.

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.

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.

Values and Ethics for Care Practice introduces readers to values and ethics and their importance in patient-centred care. Values and ethics are integral to the provision, practice and delivery of patient-centred health and social care. This book, which is an expanded and updated version of Values for Care Practice, introduces readers to these concepts and helps them understand how they can apply them to become compassionate care professionals. The patient perspective and patient voice are seen and heard throughout the book. Readers are encouraged to reflect on their personal values and on those underpinning health and social care work and to understand how values and ethics are articulated in the latest Codes of Practice. The text uses activities and case studies to enable readers to apply theory in their practice. This book will help readers to understand why good caring is more than merely a practical intervention; it also requires a personal investment and quality of character that involves genuine concern and respect for others.

The focus of bioethical debates on exceptional cases neglects the underlying values-like justice and community-that would lend to a broader, more well-rounded understanding of today's world. Discussions of ethical problems in health care too often concentrate on exceptional cases. Bioethical controversies triggered by experimental drugs, gene-edited babies, or life extension are understandably fascinating: they showcase the power of medical science and technology while addressing anxieties concerning health, disease, suffering, and death. However, the focus on rare individual cases in the media spotlight turns attention away from more pressing ethical issues that impact global populations, such as access to health care, safe food and water, and the prevention of emerging infectious diseases. In Bizarre Bioethics, Henk A.M.J. ten Have argues that this focus on bizarre cases leads to bizarre bioethics with a narrow agenda for ethical debate. In other words, although these extreme cases are undeniably real, they present a limited and skewed view of everyday moral reality. This focus also assumes that individuals are rational decision-makers, so that the role of feelings and emotions can be downgraded. Larger questions related to justice, solidarity, community, meaning, and ambiguity are not appreciated. Such questions used to be posed by philosophical and theological traditions, but they have been exorcised and marginalized in the development of bioethics. Science, ten Have writes, is not a value-free endeavor that provides facts and evidence: it is driven by underlying value perspectives that are often based on metaphors and world views from philosophical and theological traditions. Drawing on a rich analysis of the literature, ten Have explains how bioethical discussion can be enriched by these metaphors and develops a broader approach that critically delves into the imaginative world views that determine understanding of the world and human existence. Examining the roles of the metaphors of ghosts, monsters, pilgrims, prophets, and relics, ten Have illustrates how science and medicine are animated by imaginations that fuel the search for hope, salvation, healing, and a predictable future. Bizarre Bioethics invites students, researchers, policymakers and teachers interested in ethics and health care to think about the value perspectives on health and disease today.

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.

Series Information:
Professional Ethics

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.

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.

When the editors of two of the most prominent medical journals in the world--the "New England Journal of Medicine" and the "Journal of the American Medical Association (JAMA)"--were fired in the same year, under circumstances that ranged from acrimonious to politically sensational, media attention again focused on biomedical publication. The controversy highlighted yet another ethical dimension of scientific research and its publication, topics that have generated intense scrutiny in recent years. As research funding has become scarcer and competition fiercer, with links between scientific discovery and commercial applications increasingly tighter and more lucrative, allegations of misconduct have also increased. Universities and research institutions, notably the NIH, have created offices of scientific integrity and mandated educational programs to investigate such allegations and to train researchers in the highest standards of sound, ethical scientific research.

Focusing on publication ethics as an essential aspect of responsible scientific conduct, "Ethical Issues in Biomedical Publication" examines a variety of troublesome issues, including authorship, peer review, repetitive publication, conflict of interest, and electronic publishing. The contributors include the editors of distinguished biomedical journals (among them, past or present editors of "Academic Medicine, Annals of Internal Medicine, British Medical Journal, JAMA, " and the "Lancet"), humanities scholars, scientists, lawyers, and a university administrator. Chapters address specific ethical issues and offer recommendations for preventing or solving problems associated with them. The result is a book that will serve as a standard reference for biomedical researchers, authors, editors, and teachers of research ethics.

"Educators, administrators, scientists, editors, and students should all welcome this comprehensive new book. Anne Hudson Jones and Faith McLellan have gathered a veritable who's who in the field of publication ethics for biomedical research. All those with a stake in biomedical research will surely want this volume on their bookshelf."--from the Foreword by Jordan J. Cohen, M.D., President, Association of American Medical Colleges

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.

This is the third volume of a new series entitled `Current Legal Issues' that is to be published each Summer as a sister volume to `Current Legal Problems'. The third volume considers the many areas where medicine intersects with the law. Advances in medical research, reproductive science and genetic research give rise to ethical and legal issues that are well-known. At the same time changes in health care funding call into question the rights of patients, whilst a rise in medical negligence litigation calls into question the doctor's duty of care. All of these important and changing facets of law and medicine are reflected in this collection.

Key Features * Discusses the various aspects of cheating in publications: spin, protocol changes; failure to publish negative studies, including current data on the publishing industry and its issues, like the menace of predatory journals, poor peer review, coupled with lack of early education in ethics, and its significant impact on rational prescribing. * Assesses the impact of misconduct and fraud on clinicians and healthcare professionals as they attempt to balance the risk-benefit ratio which is supported by multiple contemporary studies. * Presents shocking data on bribes to physicians, journal editors and other key opinion leaders, exposing the ultimate root of the problem which lies in the economics of the healthcare system, badly in need of repair.

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.

Journalists do not often get the chance to reflect on the ethical side of their work, and the public they serve knows little about it. What the public sees is often negative- intrusive cameras, shouted questions, rude and aggressive behaviour. But journalists tend to go from one story to the next with little time to think deeply about the impact their work has on the people they cover, or how their professional practices might be refined. Written in collaboration with the Centre for Advanced Journalism at the University of Melbourne, Media Ethics and Disasters- Lessons from the Black Saturday Bushfires gives journalists the chance to reflect on the ethical issues that arose during coverage of the Black Saturday bushfires in Victoria in February 2009, and by doing so to contribute to their professional education. It presents-mostly in their own words-what journalists said about how they responded to the many dilemmas that confronted them and provides insight into the reasons for their actions. For the public this is new territory. The book illustrates the range of ethical problems that journalists confronted at the fire ground. There were good decisions an

What roles do different kinds of knowledge play in medicine? What roles should they play? What standards (epistemic, ethical, practical) should be met before knowledge is used to develop policy or practice? Medical decision-making, whether in the clinic or at the policy level, can have serious and far-reaching consequences. It is therefore important to base decisions on the best available knowledge. Yet deciding what should count as the best available knowledge is not easy. This important book addresses philosophical questions about what kinds of knowledge should be taken into account, and how knowledge should inform practice and policy. The chapters in this volume examine the relationship between knowledge and action in medical research, practice, and policy. "Knowledge" is broadly construed to include knowledge from clinical, laboratory, or social science research, and from the clinical encounter, as well as broader background assumptions prevalent in society that inform both the kinds of knowledge that are taken to be relevant to medicine and how that knowledge is interpreted in decision-making. Such knowledge may be relevant not only to clinical decision-making with regard to the care of individual patients, but also to the practice of scientific research, the development of policy and practice guidelines, and decisions made by patients or by patient advocacy groups.

Here is an overview of many of the ethical challenges facing health care practitioners today. Health providers striving for the appropriate balance between human rights and values and the objectives within their professions confront many ethical dilemmas. This helpful book explores such dilemmas from practical and philosophical perspectives and helps practitioners successfully navigate through the maze of concerns they face on a daily basis. With Ethics and Values in Long Term Health Care, readers can develop new modes of ethical thinking that will enhance their practice as they improve the quality of life of the elderly they serve. The book presents information that can be used as a catalyst for innovative thinking and a guide for positive action. Readers are encouraged to apply the lessons contained in this book to practical decisionmaking in their respective health professions. Chapters assist health practitioners and others in thinking more in-depth about the impact of their personal ethics and values on service delivery, and help them to broaden their views and enhance their decisionmaking skills. The book has a broad scope and is divided into four sections which address: Practitioner Knowledge Caregiving End of Life Choices Health Care ReformEthics and Values in Long Term Health Care helps prepare health care professionals to confront some of the major ethics and values challenges of the 1990s and beyond. This book can be used as a guide to ethical awareness, as well as a tool for teaching ethics and values or for developing programs and workshops.