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.

In Intimations of Mortality, Barbara Reich offers an empirically-based critique of the failures of end-of-life communication and decision-making in the United States. Using England and Canada as occasional foils, Reich explores why U.S. physicians, patients, and families struggle to have the conversations necessary to provide seriously ill and dying patients with medical care consistent with their preferences. Reich also shows how a number of different factors -including payment mechanisms, liability fears, cultural phenomena, communication avoidance, death denial, and clinical uncertainty -impact physician-patient communication and medical decision-making, leave patients and families without the tools they need to make informed choices, and instead leave the default practices in place. Ultimately, this groundbreaking analysis unveils the interconnectedness of the many obstacles to better communication and decision-making in end-of-life communications and offers much-needed suggestions for improvement.

Baruch A. Brody has been one of the most important voices in bioethics over the last several decades, asking new and challenging questions about a range of problems, examining recalcitrant issues in novel ways, always with the goal of offering practical solutions to complex problems. This volume presents a sustained philosophical analysis of Brody's contributions to biomedical ethics. Done well, philosophical work can clarify complex issues, facilitate creative problem solving, and lead to real-world solutions to difficult situations. Each contributor carefully and critically explores Brody's writings in biomedical ethics and the philosophy of medicine, illustrating his appreciation that thorough and critical scientific research and philosophical analysis are central to reining in the untutored human desire to ameliorate pain and suffering so that medical treatments and health care policy do more good than harm.

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.

In Suffering Presence, ethicist Stanley Hauerwas delivers a well-formed theological perspective that illuminates the moral life, particularly medical care and the care of children and the handicapped.

At the heart of research with human beings is the moral notion that the experimental subject is altruistic, and is primarily concerned for the welfare of others. Beneath the surface, however, lies a very different ethical picture. Individuals participating in potentially life-saving research sometimes take on considerable risks to their own well-being. Efforts to safeguard human participants in clinical trials have intensified ever since the first version of the World Medical Association's Declaration of Helsinki (1964) and are now codified in many national and international laws and regulations. However, a comprehensive understanding of how this cornerstone document originated, changed, and functions today does not yet exist in the sphere of human research. Ethical Research brings together the work of leading experts from the fields of bioethics, health and medical law, the medical humanities, biomedicine, the medical sciences, philosophy, and history. Together, they focus on the centrality of the Declaration of Helsinki to the protection of human subjects involved in experimentation in an increasingly complex industry and in the government-funded global research environment. The volume's historical and contemporary perspectives on human research address a series of fundamental questions: Is our current human protection regime adequately equipped to deal with new ethical challenges resulting from advances in high-tech biomedical science? How important has the Declaration been in non-Western regions, for example in Eastern Europe, Africa, China, and South America? Why has the bureaucratization of regulation led to calls to pay greater attention to professional responsibility? Ethical Research offers insight into the way in which philosophy, politics, economics, law, science, culture, and society have shaped, and continue to shape, the ideas and practices of human research.

Ethics in Community Mental Health Care: Commonplace Concerns examines everyday ethical issues that clinicians encounter as they go about their work caring for people who have severe and persistent mental disorders. Individuals (psychiatrists, social workers, case managers, nurses, psychologists, peer counselors, primary care physicians) who serve on the front line of community mental health clinical and social services find that they must deal, on a daily basis, with significant ethical dilemmas that involve personal, social, and policy matters: overstepping personal boundaries and coercive practices, dealing with violence in the home and in the workplace, breaching confidentiality, and ensuring the rights and welfare of vulnerable individuals.

This book prompts and provokes readers to recognize, to analyze, to reflect upon, and to respond to the range of commonplace ethical concerns that arise in community mental health care practice with persons who have mental disorders that may impede their ability to protect their own interests.

Health systems need to set priorities fairly. In one way or another, part of this important task will fall to physicians. How do they make judgments about resource stewardship, and how should they do so? How can they make such decisions in a manner that is compatible with their clinical duties to patients? In this book, philosophers, bioethicists, physicians, lawyers and health policy experts make the case that priority setting and rationing contribute significantly to the possibility of affordable and fair healthcare and that clinicians play an indispensable role in that process. The book depicts the results of a survey of European physicians about their experiences with rationing and other cost containment strategies, and their perception of scarcity and fairness in their health care systems. Responding to and complementing these findings, commentators discuss why resource allocation and bedside rationing is necessary and justifiable. The book explores how bedside rationing relates to clinical judgments about medical necessity and medical indications, marginal benefits, weak evidence based medicine, off-label use. The book highlights how comparative studies of health care systems can advance more effective and fair bedside rationing through learning from one another. From a practical standpoint, the book offers a number of strategies for health care systems and clinicians to work in tandem to allocate and ration resources as fairly as possible: how to foster more attention to fairness when rationing at the bedside, how to avoid exacerbating health disparities when allocating resources, how to teach about bedside rationing to students, how to discuss rationing more explicitly in the public arena and in the doctor's office.

Much has been written about whether end-of-life law should change and what that law should be. However, the barriers and facilitators of such changes - law reform perspectives - have been virtually ignored. Why do so many attempts to change the law fail but others are successful? International Perspectives on End-of-Life Law Reform aims to address this question by drawing on ten case studies of end-of-life law reform from the United Kingdom, the United States, Canada, the Netherlands, Belgium and Australia. Written by leading end-of-life scholars, the book's chapters blend perspectives from law, medicine, bioethics and sociology to examine sustained reform efforts to permit assisted dying and change the law about withholding and withdrawing life-sustaining treatment. Findings from this book shed light not only on changing end-of-life law, but provide insight more generally into how and why law reform succeeds in complex and controversial social policy areas.

Bioethical Prescriptions collects F.M. Kamm's articles on bioethics, which have appeared over the last twenty-five years and which have made her among the most influential philosophers in this area. Kamm is known for her intricate, sophisticated, and painstaking philosophical analyses of moral problems generally and of bioethical issues in particular. This volume showcases these articles - revised to eliminate redundancies - as parts of a coherent whole. A substantive introduction identifies important themes than run through the articles. Section headings include Death and Dying; Early Life (on conception and use of embryos, abortion, and childhood); Genetics and Other Enhancements (on cloning and other genetic technologies); Allocating Scarce Resources; and Methodology (on the relation of moral theory and practical ethics).

THE TRUE CRIME BOOK OF THE YEAR AND SUNDAY TIMES TOP 10 BESTSELLER 'One of the most fascinating books I have read in a long time. Engrossing, a haunting page-turner. A book I could not put down' The Times, BOOKS OF THE YEAR __________ Meet the forensic pathologist, Dr Richard Shepherd. He solves the mysteries of unexplained or sudden death. He has performed over 23,000 autopsies, including some of the most high-profile cases of recent times; the Hungerford Massacre, the Princess Diana inquiry, and 9/11. He has faced serial killers, natural disaster, 'perfect murders' and freak accidents. His evidence has put killers behind bars, freed the innocent, and turned open-and-shut cases on their heads. Yet all this has come at a huge personal cost. Unnatural Causes tells the story of not only the cases and bodies that have haunted him the most, but also how to live a life steeped in death. Thoughtful, revealing, chilling and always unputdownable, if you liked All That Remains, War Doctor and This is Going to Hurt you'll love this. **Pre-order Dr Richard Shepherd's new book THE SEVEN AGES OF DEATH now** __________ 'Gripping, grimly fascinating, and I suspect I'll read it at least twice' Evening Standard 'A deeply mesmerising memoir of forensic pathology. Human and fascinating' Nigella Lawson 'An absolutely brilliant book. I really recommend it, I don't often say that but it's fascinating' Jeremy Vine, BBC Radio 2 'Puts the reader at his elbow as he wields the scalpel' Guardian 'Fascinating, gruesome yet engrossing' Richard and Judy, Daily Express 'Fascinating, insightful, candid, compassionate' Observer

Experiments in Love and Death is about the depth and complexity of the ethical issues that arise in illness and medicine. In his concept of 'microethics' Paul Komesaroff provides an alternative to the abstract debates about principles and consequences that have long dominated ethical thought. He shows how ethical decisions are everywhere: in small decisions, in facial expressions, in almost inconspicuous acts of recognition and trust. Through powerful descriptions of case studies and clear and concise explanations of contemporary philosophical theory the book brings discussions about ethics in medicine back to where they belong - to the level of the everyday experience where people actually live, suffer and hope. A fresh and evocative look at the changing world of ethics as it applies to health and illness, this is an important book for all those touched by illness or suffering.

Developing best practices and ethical systems to protect and enhance patient safety. Human errors occur all too frequently in medical practice settings. One sobering recent report claimed that medical errors are the third leading cause of death in the United States. Hoping to reverse this disturbing trend but wondering why it is that things usually go well despite errors, John D. Banja's Patient Safety Ethics lays out a model that advocates vigilance, mindfulness, compliance, and humility as core ethical principles of patient safety. Arguing that the safe provision of healthcare is one of the most fundamental moral obligations of clinicians, Banja surveys the research literature on harm-causing medical errors to explore the ethical foundations of patient safety and to reduce the severity and frequency of medical error. Drawing on contemporary scholarship on quality improvement, risk management, and medical decision making, Banja also relies on a novel source of information to illustrate patient safety ethics: medical malpractice suits. Providing professional perspective with insights from prominent patient safety experts, Patient Safety Ethics identifies hazard pitfalls and suggests concrete ways for clinicians and regulators to improve patient safety through an ethically cultivated program of "hazard awareness."

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.

In 1978, the World Health Organization (WHO) designated the year 2000 as the "due date" for world health. The Alma Ata declaration set the turn of the century as the target for a level of health that would permit all people of the world to lead a socially and economically productive life. ' At that (magic but arbitrary) date most infectious diseases and many chronic conditions, including diabetes and cancer, were expected to have been eradicated or at least controlled. Such predictions were based on solid foundations. In the 1 20 h century, and particularly since the 1970's, Western science and technology based (or "modern") medicine has made quantum leaps in numerous areas as diverse as pharmacology, genetic and molecular biology, surgical techniques, infertility treatments, and pre- and neo-natal care. This impressive trajectory of progress, which continues unabatedly, gave every reason to assume that come the year 2000 humanity would finally be free from many of its ancient scourges. However, as we are all too well aware, the new millennium witnesses also ever more terrifying threats to our health as a result of the emergence of 2 AIDS in the early 80's, the resurgence of infectious diseases such as 3 tuberculosis and malaria, now drug resistant, the absence of significant breakthroughs in the treatment of cancer and cardiovascular diseases, and the continuing dramatic gap in health care between industrialized and developing countries, to mention but a few examples.

Essential Primary Care aims to provide undergraduate students with a comprehensive overview of the clinical problems encountered in primary care. It covers the structure of primary care in the UK, disease prevention and the management of common and important clinical presentations from infancy to old age. Case studies are used in every chapter to illustrate key learning points. The book provides practical advice on how to consult with patients, make sense of their symptoms, explain things to them, and manage their problems. Essential Primary Care: Is structured in five sections: - The building blocks of primary care: its structure and connection with secondary care, the consultation, the process of making a diagnosis, prescribing, and ethical issues - Health promotion - Common and important presenting problems in roughly chronological order - Cancer - Death and palliative care Gives advice on how to phrase questions when consulting with patients and how to present information to patients Provides advice on how management extends to prescribing - often missing from current textbooks Contains case studies within each chapter which reflect the variety of primary care and provide top tips and advice for consulting with patients Supported by a companion website at www.wileyessential.com/primarycare featuring MCQs, EMQs, cases and OSCE checklists

This book examines the ethics of end of life care, focusing on the kinds of decisions that are commonly made in clinical practice. Specific attention is paid to the intensification of treatment for terminal symptoms, particularly pain relief, and the withdrawal and withholding of care, particularly life-saving or life-prolonging medical care. The book is structured into three sections. The first section contains essays examining end of life care from the perspective of moral theory and theology. The second sets out various conceptual terms and distinctions relevant to decision-making at the end of life. The third section contains chapters that focus on substantive ethical issues. This format not only provides for a comprehensive analysis of the ethical issues that arise in the context of end of life care but allows readers to effectively trace the philosophical, theological and conceptual underpinnings that inform their specific interests. This work will be of interest to scholars working in the area as well as clinicians, specialists and healthcare professionals who encounter these issues in the course of their practice.