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.

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.

This book discusses the influence of the pharmaceutical industry on the practice of medicine, and the observed and potential pitfalls of such partnerships. It argues that the pharmaceutical industry has become indispensable to many of the activities of the medical profession across the pharmaceutical product lifecycle, and examines the regulatory, ethical, professional and institutional difficulties that arise from these interactions. With data drawn from over 80 qualitative accounts from medical, pharmaceutical, regulatory and healthcare professionals, this book uses both Hungary and the Netherlands as case studies to demonstrate the potential problem of undue pharmaceutical industry influence within the relationships fostered with the profession of medicine. Chapters systematically describe the lifecycle of a pharmaceutical product from research to distribution, demonstrating the interdependency of industry and medicine. Arguing that the medical profession should be a buffer between the pharmaceutical industry interests and patient interests, the book explores how undue industry influence weakens the ability of the medical profession to do so. Using the theory of institutional corruption, the book aims to analyze how conflict of interest and the weakening of institutional imperatives is a result of institutional interactions rather than individual actions. Appropriate for students and researchers of the pharmaceutical industry, corporate corruption, and those working in NGOs and policy making, this unique volume is an comprehensive look at the complex relationship between medicine and pharmacy.

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

The Human Embryo in vitro explores the ways in which UK law engages with embryonic processes under the Human Fertilisation and Embryology Act 1990 (as amended), the intellectual basis of which has not been reconsidered for almost thirty years. McMillan argues that in regulating 'the embryo' - that is, a processual liminal entity in itself - the law is regulating for uncertainty. This book offers a fuller understanding of how complex biological processes of development and growth can be better aligned with a legal framework that purports to pay respect to the embryo while also allowing its destruction. To do so it employs an anthropological concept, liminality, which is itself concerned with revealing the dynamics of process. The implications of this for contemporary regulation of artificial reproduction are fully explored, and recommendations are offered for international regimes on how they can better align biological reality with social policy and law.

This interdisciplinary collection of essays demonstrates how the ethical and political problems we are confronted with today have come to focus largely on life. The contributors to this volume define and assess the specific meaning of life itself. It is only by doing so that we can understand why life has become an all-encompassing problem, why all questions, especially ethical and political, have become vital questions. We have reached a moment in history where every distinction and opposition is no longer in relation to life, but within it, and where life is at once a theoretical and practical problem. This book throws light on this nexus of problems at the heart of contemporary debates in bioethics and biopolitics. It helps us understand why and how life is understood, valued, cared for and framed today. Taking a genuinely transdisciplinary approach, these essays demonstrate how life is a multifaceted problem and how diverse the origins, foundations and also consequences of bioethics and biopolitics therefore are.

Handbook of Nutrition and Diet in Palliative Care, Second Edition, is a comprehensive guide, providing exhaustive information on nutrition and diet in terminal and palliative care. It covers physical, cultural and ethical aspects, bridging the intellectual divide in being suitable for novices and experts alike. Following in the tradition of its predecessor, chapters contain practical methods, techniques, and guidelines along with a section on applications to other areas of palliative care. Each chapter features key facts highlighting important areas, summary points, and ethical issues. FEATURES * Use of cannabinoids in palliative nutrition care * Pain control in palliative care * Communications in palliative/end-of-life care: aspects of bad news * Anorexia in cancer: appetite, physiology, and beyond * Palliative care in severe and enduring eating disorders * Linking food supplementation and palliative care in HIV * Eating-related distress in terminally ill cancer patients and their family members * Palliative care of gastroparesis * Preoperative nutrition assessment and optimization in the cancer patient * Childhood leukemia, malnutrition, and mortality as components of palliative care * End-of-life decisions in persons with neurodevelopmental disorders * Resources: listing web sites, journals, books and organizations

In this work, Carol V.A. Quinn (re)constructs the survivors' arguments in the debate concerning the ethics of using Nazi medical data, showing what it would mean to take their claims seriously. She begins with a historical case and presents arguments that help make sense of the following claims: 1) Using the data harms the survivors by violating their dignity; 2) The survivors are the "living data," and so when we use the data we use them; 3) The data is really, not merely symbolically, evil and we become morally tainted when we engage it; and 4) The survivors are the real moral experts in this debate, and so we should take seriously what they say. Quinn's approach is interdisciplinary, incorporating philosophy, psychology, trauma research, survivors' testimony, Holocaust poetry, literature, and the Hebrew Bible.

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

This is a presentation of the case for challenging complacency and reconsidering the extent to which British law has interpreted abortion and constructed a medical model in such a way as to place the control over access to abortion services with the medical profession. Recognizing that abortion has slipped from the political (and specifically feminist) agenda, at least in the UK, the author argues that this systematic medicalization of abortion has rendered women powerless. She acknowledges that repoliticizing abortion - and recognizing how gender affects how power is exercised over women - creates its own risks and may mean that feminists face a potentially lethal backlash. But, she maintains, the failure to do so could close down avenues of choice and control at a time when fundamentalist pressures to eliminate abortion are becoming increasingly powerful. This critique of the medical, legal and political issues surrounding abortion in the UK, reflects the changes, both insidious and profound, in the range of medical technologies available (including RU486), in case law, legal theory and feminist thinking since Keown's 1988 study Abortion, Doctors and the Law.

This is a comprehensive discussion of the ethical issues involved in i nforming patients of their rights and participation in medical treatme nt and research. The 30 chapters provide reference on a subject of maj or importance in medical ethics.

This book provides an up-to-date description of cross-cultural aspects of end-of-life decision-making. The work places this discussion in the context of developments in the United States such as the emphasis on patient informed consent, "right to die" legal cases, and the federal Patient Self-Determination Act. With the globalization of health care and increased immigration from developing to developed countries, health care professionals are experiencing unique challenges in communicating with seriously ill patients and their families about treatment options as well as counselling all patients about advance medical care planning. While many Western countries emphasize individual autonomy and patient-centered decision-making, cultures with a greater collectivist orientation have, historically, often protected patients from negative health information and emphasized family-centered decision-making. In order to place these issues in context, the history of informed consent in medicine is reviewed. Additionally, cross-cultural issues in health care decision-making are analysed from the perspective of multiple philosophical theories including deontology, utilitarianism, virtues, principlism, and communitarian ethics. This book is a valuable addition to courses on end-of-life care, death and dying, cross-cultural health, medical anthropology, and medical ethics and an indispensable guide for healthcare workers dealing with patients coming from various cultural backgrounds.

This thoroughly updated third edition lays a solid foundation for understanding the intersection of law, ethics and the rights of the patient in the context of everyday nursing and health care practice. Outlining the key legal and ethical principles relevant to nurses, Essential Law and Ethics In Nursing: Patients, Rights and Decision-Making, previously entitled Patients' Rights: Law and Ethics for Nurses, uses an easy-to-read style that conveys key principles in an accessible way. It: provides a clear understanding not only of basic legal provisions in health care but also of wider issues relating to human rights; covers topics such as ethical decision-making, the regulation of nursing, confidentiality, laws concerning human rights, safe practice, vulnerable people, elder abuse and employment regulations; and includes thinking points, case studies and relevant case law to help link theory with practice. This is essential reading for nurses and an important reference for midwives and allied health professionals.

This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector's refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason. The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is plausible to the extent that it mimics the 'reason-giving requirement' for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient's request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy.

Through a series of essays contributed by clinicians, medical historians, and prominent moral philosophers, "Cognitive Disability and Its Challenge to Moral Philosophy" addresses the ethical, bio-ethical, epistemological, historical, and meta-philosophical questions raised by cognitive disabilityFeatures essays by a prominent clinicians and medical historians of cognitive disability, and prominent contemporary philosophers such as Ian Hacking, Martha Nussbaum, and Peter SingerRepresents the first collection that brings together philosophical discussions of Alzheimer's disease, intellectual/developmental disabilities, and autism under the rubric of cognitive disabilityOffers insights into categories like Alzheimer's, mental retardation, and autism, as well as issues such as care, personhood, justice, agency, and responsibility

One of modern healthcare's most controversial areas, reproductive medicine is an emerging discipline that fosters hugely divergent opinions on topics such as laboratory techniques, clinical management and ethical considerations. Highlighting over 50 contentious topics in reproductive medicine, this book presents expertly argued opinions are presented for and against, often with diametrically opposing views about management. Debates such as these are being increasingly used as learning tools, helping participants develop their critical thinking skills and showing that context is vital when making decisions. Issues discussed include limits on IVF provision, ethical queries about sex selection, embryology, and ovarian stimulation. Authors are authorities in their field, combining years of experience with fresh and innovative ideas to structure their arguments. Readers will gain an insight into topical controversies, critically evaluating the different sides to enhance their own clinical practice.

This book demonstrates the utility of healthcare law, policy and professional standards in analysing the ethical issues that arise in the provision of health services. Rejecting moral absolutes, its examination of health law, policy and professional standards and of how societies codify beliefs is pertinent to ethical analysis - and also offers the possibility of practical solutions to healthcare challenges across the globe. Comparing and contrasting ethical and policy issues from countries around the world (with a focus on Asia, Europe and the USA), this book addresses such issues as conflict of interest, the balance between healthcare quality and cost, and the effect of geography and demographics on access to healthcare. Critique and discussion are tempered with suggestions for the evaluation of policy and systems; its pragmatic approach suggests how theory can and should inform practice. Health Policy and Ethics offers refreshing reading for professionals and academics in healthcare, medical ethics and policy. Researchers and students with an interest in healthcare delivery, comparative healthcare policy analysis, and health and human rights will also find much of interest. 'This book offers an unusual and welcome perspective on the rights and wrongs of health policy, with comparisons across space and time, from China to Italy, from Malaysia to India, from pharmaceutical ethics to the overarching topic of rationing.' Theodore Marmor, Professor Emeritus, Yale University School of Management Ethical analysis in this domain is not easy, as things held sacred will at times conflict, and of course within a given society there will be variability in values and priorities between individuals and over time. The anticipated difficulties serve to further emphasize that the ongoing ethical analysis should include input from those with experience and skill at that task. This book successfully demonstrates that point. In addition, Health Policy and Ethics is a welcome bridge between these two fields, and a very worthwhile read for individuals whose primary interest lies in either one. - From the Foreword by Mark R. Mercurio

When is a human study ethical? For years, science and society have struggled with this question. Experts have put great effort into developing ethical principles and rules that adequately protect and respect volunteers in studies aimed at improving human health. But experts have missed something important. They have created a research ethics system without the help of people who know what it is like to be a research subject. This is a serious omission. Experienced research subjects can make valuable contributions to research ethics. People who have been in studies have information about the experience that other people can overlook. Their experience as subjects gives them special insights into ethics, too. Experienced subjects also know about problems that can lead people to refuse to join studies, or drop out before studies are complete. Scientists and ethicists often speak of subjects as partners in research, but the reality is quite different. Experienced subjects are rarely appointed to the advisory groups that create guidelines for ethical research, or to the committees that review individual studies to determine whether they meet ethical and regulatory standards. A large body of work describes the perceptions and viewpoints of people who have participated in research. But experts rarely use this material to guide improvements in human subject protection. Although subjects have the power to decide whether to participate in a study, they have little control over anything else that goes on in research. Silent Partners moves research subjects to the forefront. It examines what research participation is like for healthy volunteers and patients. It explains why subjects' voices should influence research ethics. Silent Partners shows how experienced research subjects can become real-not just symbolic-partners in research.

Research holds a key to preventing and effectively treating mental disorders, including ADHD, depression, schizophrenia, and substance abuse. Yet even as research holds out promise, mental health researchers face numerous ethical challenges. Responsible for ensuring participants are able and willing to grant consent, researchers must also constantly protect privacy and confidentiality. But for so many situations, the appropriate decisions are not so clear. An individual with cognitive deficits may have difficulty understanding a research study and granting informed consent, but nevertheless wants to participate. Many studies gather private information about medical records or illegal behaviour that could lead to emotional, social, or legal harm if shared, yet state laws and institutional review boards may require researchers to breach confidentiality in specific situations. Moreover, mental health consumers and other vulnerable research participants are frequently familiar with historical cases of abuse of human subjects, and may be mistrustful of researchers or fear exploitation. At the same time, researchers are often frustrated when they feel that advocates or institutional review boards erect barriers to research, even while failing to enhance the ethical treatment of participants. Ethical research is rarely simply about avoiding bad activities, and more frequently about how to pursue good research when multiple values and commitments conflict. Ethics in Mental Health Research explores how ethical issues arise in mental health research, and offers guidance to researchers who seek to comply with regulations while conducting research that is at once ethical and scientifically credible. Case studies used throughout illustrate a variety of situations and effective problem-solving strategies. This book is essential reading for mental health researchers, IRB members, and research advocates.

Biotechnologies already on the horizon will enable us to be smarter, have better memories, be stronger and quicker, have more stamina, live longer, be more resistant to diseases, and enjoy richer emotional lives. To some of us, these prospects are heartening; to others, they are dreadful. In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement. These raise enduring questions about what it is to be human, about individuality, about our relationship to nature, and about what sort of society we should strive to have. Allen E. Buchanan urges that the debate about enhancement needs to be informed by a proper understanding of evolutionary biology, which has discredited the simplistic conceptions of human nature used by many opponents of enhancement. He argues that there are powerful reasons for us to embark on the enhancement enterprise, and no objections to enhancement that are sufficient to outweigh them.

For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions. Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and, medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition - as well as teachings of bishops and popes - understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious. "Medical Care at the End of Life" addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.

In this book, scholars with different disciplinary and national backgrounds argue for possible answers and analyse case studies on current issues of governance in biomedical research. These issues comprise among others the research-care distinction, risk evaluation in early human trials, handling of incidental findings, nocebo effects, cluster randomized trials, publication bias, or consent in biobank research. This book demonstrates how new technologies and research possibilities multiply or intensify already known governance challenges, leaving room for ethical analysis and complex moral choices. Clinical researchers, research ethics committee members and research ethicists have all to deal with such challenges on a daily basis. While general reflection on core concepts of research ethics is seldom pointless, those confronted with hard moral choices do need more practical and contextualized reflection on the said issues. This book particularly provides such contextualized reflections and aims to inform all those who study, conduct, regulate, fund, or participate in biomedical research.