Can religious arguments provide a reasonable, justified basis for restrictive (coercive) public policies regarding numerous ethically and politically controversial medical interventions, such as research with human embryos, pre-implantation genetic diagnosis, or using artificial wombs? With Rawls, we answer negatively. Liberally reasonable policies must address these controversial technologies on the basis of public reasons accessible to all, even if not fully agreeable by all. Further, public democratic deliberation requires participants to construct these policies as citizens who are agnostic with respect to the truth of all comprehensive doctrines, whether secular or religious. The goal of these deliberations is practical, namely, to identify reasonable policy options that reflect fair terms of cooperation in a liberal, pluralistic society. Further, religious advocates may participate in formal policymaking processes as reasonable liberal citizens. Finally, public reason evolves through the deliberative process and all the novel technological challenges medicine generates for bioethics and related public policies.

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

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

This Element traces the origins and development of bioethics, the principles and values involved in the discipline, and the roles of justice among these principles and values. The main tasks given to the concept of justice have since the late 1970s been nondiscrimination in research, prioritization in medical practice, and redistribution in healthcare. The Element argues that in a world challenged by planet-wide political and environmental threats this is not sufficient. The nature and meaning of justice has to be rethought. The Element does this by dissecting current bioethical approaches in the light of theories of justice as partly clashing interpretations of equality. The overall findings are twofold. Seen against the background of global concerns, justice in bioethics has become a silent guardian of economic sustainability. Seen against the same background, we should set our aims higher. Justice can, and must, be put to better use than it presently is. This title is also available as Open Access on Cambridge Core.

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.

Increasing quantities of information about our health, bodies, and biological relationships are being generated by health technologies, research, and surveillance. This escalation presents challenges to us all when it comes to deciding how to manage this information and what should be disclosed to the very people it describes. This book establishes the ethical imperative to take seriously the potential impacts on our identities of encountering bioinformation about ourselves. Emily Postan argues that identity interests in accessing personal bioinformation are currently under-protected in law and often linked to problematic bio-essentialist assumptions. Drawing on a picture of identity constructed through embodied self-narratives, and examples of people's encounters with diverse kinds of information, Postan addresses these gaps. This book provides a robust account of the source, scope, and ethical significance of our identity-related interests in accessing - and not accessing - bioinformation about ourselves, and the need for disclosure practices to respond appropriately. This title is also available as Open Access on Cambridge Core.

This Element examines the main ethical aspects of consciousness It argues that consciousness is not intrinsically valuable but has value or disvalue for individuals depending on its phenomenology (what it is like to be aware) and content (what one is aware of). These two components of awareness shape normative judgments about how ordered, disordered, altered, restored, diminished and suppressed conscious states can benefit or harm individuals. They also influence moral judgments about whether intentionally causing these states is permissible or impermissible and how these states can affect behavior. After describing its neurobiological basis, this Element discusses ethical and legal issues in six categories of consciousness: phenomenal and access consciousness; intraoperative awareness; prolonged disorders of consciousness, dissociative disorders, the role of consciousness in determining death; and altering and suppressing awareness near the end of life.

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.

Health research around the world relies on access to data, and much of the most valuable, reliable, and comprehensive data collections are held by governments. These collections, which contain data on whole populations, are a powerful tool in the hands of researchers, especially when they are linked and analyzed, and can help to address "wicked problems" in health and emerging global threats such as COVID-19. At the same time, these data collections contain sensitive information that must only be used in ways that respect the values, interests, and rights of individuals and their communities. Sharing Linked Data for Health Research provides a template for allowing research access to government data collections in a regulatory environment designed to build social license while supporting the research enterprise.

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.

Series Information:
Professional Ethics

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

Providing a concise and accessible overview of the design, implementation and management of medical software, this textbook will equip students with a solid understanding of critical considerations for both standalone medical software (software as a medical device/SaMD) and software that is integrated into hardware devices. It includes: practical discussion of key regulatory documents and industry standards, and how these translate into concrete considerations for medical software design; detailed coverage of the medical software lifecycle process ; accessible introduction to quality and risk management systems in the context of medical software; succinct coverage of essential topics in data science, machine learning, statistics, cybersecurity, software engineering and healthcare bring readers up-to-speed; six cautionary real-world case studies illustrate the dangers of improper or careless software processes. Accompanied by online resources for instructors, this is the ideal introduction for undergraduate students in biomedical engineering, electrical engineering and computer science, junior software engineers, and digital health entrepreneurs.

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.

'Astonishing' Stephen Fry 'Exceptional' Douglas Stuart, author of the Booker Prize-winning SHUGGIE BAIN 'Now is the time for this book' DBC Pierre, author of the Booker Prize-winning VERNON GOD LITTLE 'Funny. Disturbing. Brilliant' Lily Allen Funny, smart, damaged, Tom is lost in the machinery of the British mental health system, talking to a voice no one else can hear; the voice of Malamock, the Octopus God - sometimes loving, sometimes cruel, but always there to fill his life with meaning. Once an outstanding law student, Tom is now cared for by his long-suffering sister Tess, who encourages him into an experimental drugs trial that promises to silence the voice forever. The Octopus God, however, does not take kindly to being threatened... Deeply moving and tragi-comic, The Octopus Man is a bravura literary performance that asks fundamental questions about belief and love.

Regulators have been more permissive for medical devices compared to their drug and biologic counterparts. While innovative products can thereby reach consumers more quickly, this approach raises serious public health and safety concerns. Additionally, the nature of medical devices is rapidly changing, as software has become as important as hardware. Regulation must keep pace with the current developments and controversies of this technology. This volume provides a multidisciplinary evaluation of the ethical, legal, and regulatory concerns surrounding medical devices in the US and EU. For medical providers, policymakers, and other stakeholders, the book offers a framework for the opportunities and challenges on the horizon for medical device regulation. Readers will gain a nuanced overview of the latest developments in patient privacy and safety, innovation, and new regulatory laws. This book is also available as Open Access on Cambridge Core.

Regulators have been more permissive for medical devices compared to their drug and biologic counterparts. While innovative products can thereby reach consumers more quickly, this approach raises serious public health and safety concerns. Additionally, the nature of medical devices is rapidly changing, as software has become as important as hardware. Regulation must keep pace with the current developments and controversies of this technology. This volume provides a multidisciplinary evaluation of the ethical, legal, and regulatory concerns surrounding medical devices in the US and EU. For medical providers, policymakers, and other stakeholders, the book offers a framework for the opportunities and challenges on the horizon for medical device regulation. Readers will gain a nuanced overview of the latest developments in patient privacy and safety, innovation, and new regulatory laws. This book is also available as Open Access on Cambridge Core.

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.

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.

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.

In this eye-opening look at the doctor-patient decision-making process, physician and law professor Jay Katz examines the time-honored belief in the virtue of silent care and patient compliance. Historically, the doctor-patient relationship has been based on a one-way trust--despite recent judicial attempts to give patients a greater voice through the doctrine of informed consent. Katz criticizes doctors for encouraging patients to relinquish their autonomy, and demonstrates the detrimental effect their silence has on good patient care. Seeing a growing need in this age of medical science and sophisticated technology for more honest and complete communication between physician and patients, he advocates a new, informed dialogue that respects the rights and needs of both sides.

In a new foreword to this edition of "The Silent World of Doctor and Patient," Alexander Morgan Capron outlines the changes in medical ethics practice that have occurred since the book was first published in 1984, paying particular attention to the hotly debated issues of physician-assisted suicide and informed consent in managed care.

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.

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.