Historically and across societies people with disabilities have been stigmatized and excluded from social opportunities on a variety of culturally specific grounds. In this collection, the authors explore the impact that the philosophical framing of disability can have on public policy questions, in the clinic, in the courtroom, and elsewhere. They examine the implications of this understanding for legal and policy approaches to disability, strategies for allocating and accessing health care, the implementation of the Americans with Disabilities Act, health care rights, and other legal tools designed to address discrimination. This volume should be read by anyone seeking a balanced view of disability and an understanding of the connection between the framing of disability and policies that have a real-world impact on individuals.

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."

Fundamental questions about the morality of pediatric medical research persist despite years of debate and the establishment of strict codes of ethics. Is it ever permissible to use a child as a means to an end? How much authority should parents have over decisions about research involving their children? Should children or their parents be paid for participation in research? Most importantly, how can the twin goals of access to the benefits of clinical research and protection from research risk be reconciled? Promoting more thoughtful attention to the complex ethical problems that arise when research involves children, this fully updated new edition of Ethics and Research with Children presents 14 case studies featuring some of the most challenging and fascinating ethical dilemmas in pediatric research. Each chapter begins with a unique case vignette, followed by rich discussion and incisive ethical analysis. Chapters represent a host of current controversies and are contributed by leading scholars from a variety of disciplines that must grapple with how to best protect children from research risk while driving innovation in the fight against childhood diseases. Chapters end with questions for discussion, providing faculty and students with accessible starting points from which to explore more in depth the thorny issues that are raised. In the final chapter, the editors provide a synthesis and summary that serve as a capstone and companion to the case-based chapters. Unique in its specific focus on research, Ethics and Research with Children provides a balanced and thorough account of the enduring dilemmas that arise when children become research subjects, and will be essential reading for those involved with pediatric research in any context.

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.

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.

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 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.

Renowned philosophers and medical ethicists debate and discuss the profoundly important concepts of disease and health. Christopher Boorse begins with an extensive reexamination of his seminal definition of disease as a value-free scientific concept. In responding to all those who criticized this view, which came to be called "naturalism" or "neutralism," Boorse clarifies and updates his landmark ideas on this crucial question. Other distinguished thinkers analyze, develop, and oftentimes defend competing, nonnaturalistic theories of disease. Their combined thoughts review and update an issue of central importance in bioethics today.

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.

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.

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.

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.

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.

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

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

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.

Who should define what constitutes ethical and lawful medical practice? Judges? Doctors? Scientists? Or someone else entirely? This volume analyses how effectively criminal law operates as a forum for resolving ethical conflict in the delivery of health care. It addresses key questions such as: how does criminal law regulate controversial bioethical areas? What effect, positive or negative, does the use of criminal law have when regulating bioethical conflict? And can the law accommodate moral controversy? By exploring criminal law in theory and in practice and examining the broad field of bioethics as opposed to the narrower terrain of medical ethics, it offers balanced arguments that will help readers form reasoned views on the ethical legitimacy of the invocation and use of criminal law to regulate medical and scientific practice and bioethical issues.

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.

This book provides a clear and comprehensive introduction to contemporary bioethics. It also presents provocative, philosophically informed arguments on current bioethical issues. Holland engages with debates ranging from the more familiar such as euthanasia, advance decisions to refuse treatment, and new reproductive technologies to the philosophical implications of recent developments in genetics, including prenatal genetic therapy, genetic enhancement and human cloning. The book is built around four crucial themes. The first is moral status: what are the implications of the moral status of human embryos or animals for our biomedical practices? The second theme life, death and killing looks at the ethics of ending, or failing to lengthen, human life. Holland then explores various questions of personal identity raised in contemporary bioethical debates. Finally, he presents and develops a version of the argument from nature which continues to be influential in bioethics in order to make sense of the objection that some biomedical innovations are 'unnatural'. Structuring the discussions in this way creates an engaging introduction to bioethics that is an ideal textbook for students, whilst offering much to stimulate colleagues in the field. This second edition has been thoroughly and comprehensively updated to reflect the most recent advances in bioethics, and includes an entirely new chapter on the ethical treatment of patients in the minimally conscious state.

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.

Strive for health equity and surmount institutional oppression when treating marginalized populations with this distinct resource!This unique text provides a framework for delivering culturally safe clinical care to LGBTQIA populations filtered through the lens of racial, economic, and reproductive justice. It focuses strongly on the social context in which we live, one where multiple historical processes of oppression continue to manifest as injustices in the health care setting and beyond. Encompassing the shared experiences of a diverse group of expert health care practitioners, this book offers abundant examples, case studies, recommendations, and the most up-to-date guidelines available for treating LGBTQIA patient populations. Rich in clinical scenarios that describe best practices for safely treating patients, this text features varied healthcare frameworks encompassing patient-centered and community-centered care that considers the intersecting and ongoing processes of oppression that impact LGBTQIA people every day--particularly people of color. This text helps health providers incorporate safe and culturally appropriate language into their care, understand the roots and impact of stigma, address issues of health disparities, and recognize and avoid racial or LGBTQIA microaggressions. Specific approaches to care include chapters on sexual health care, perinatal care, and information about pregnancy and postpartum care for transgender and gender-expansive people. Key Features: Emphasizes patient-centered care incorporating an understanding of patient histories, safety needs, and power imbalances Provides tools for clinician self-reflection to understand and alleviate implicit bias Fosters culturally safe language and communication skills Presents abundant patient scenarios including specific dos and don'ts in patient treatment Includes concrete objectives, conclusions, terminology, and references in each chapter and discussion questions to promote critical thought Offers charts and information boxes to illuminate key information

Research using genetic data raises various concerns relating to privacy protection. Many of these concerns can also apply to research that uses other personal data, but not with the same implications for failure. The norms of exclusivity associated with a private life go beyond the current legal concept of personal data to include genetic data that relates to multiple identifiable individuals simultaneously and anonymous data that could be associated with any number of individuals in different, but reasonably foreseeable, contexts. It is the possibilities and implications of association that are significant, and these possibilities can only be assessed if one considers the interpretive potential of data. They are missed if one fixates upon its interpretive pedigree or misunderstands the meaning and significance of identification. This book demonstrates how the public interest in research using genetic data might be reconciled with the public interest in proper privacy protection.