The Abortion Act 1967 may be the most contested law in UK history, sitting on a fault line between the shifting tectonic plates of a rapidly transforming society. While it has survived repeated calls for its reform, with its text barely altered for over five decades, women's experiences of accessing abortion services under it have evolved considerably. Drawing on extensive archival research and interviews, this book explores how the Abortion Act was given meaning by a diverse cast of actors including women seeking access to services, doctors and service providers, campaigners, judges, lawyers, and policy makers. By adopting an innovative biographical approach to the law, the book shows that the Abortion Act is a 'living law'. Using this historically grounded socio-legal approach, this enlightening book demonstrates how the Abortion Act both shaped and was shaped by a constantly changing society.

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.

Truth, Trust and Medicine investigates trust and honesty in medicine. It looks at the doctor-patient relationship, raising questions which disturb notions of patients' autonomy and self-determination, such as withholding information and consent and covert surveillance in care units. It will be of interest to those working in medical ethics and applied philosophy, and a valuable resource for practitioners of medicine.

This Element is a survey of the field of pathographies of mental illness. It explores classic texts in the field as well as other selected contemporary memoirs. In doing so, the reader is introduced to psychiatric information about various mental illnesses through a narrative lens, emphasizing experience. Because clinical research is evidenced-based and aims to produce generalizable knowledge (i.e., trends), the reading of pathographies can complement these findings with practical experiential insights. By pairing psychiatric information with pathographies, certain personal themes become apparent that are different from the empirical trends identified by scientific and medical researchers. Based on the survey presented here, this Element identifies seven such themes, laying the foundation for future research, inquiry, practice, and policy.

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.

The COVID-19 crisis has transformed the highly specialized issue of what constitutes reliable medical evidence into a topic of public concern and debate. This book interrogates the assumption that evidence means the same thing to different constituencies and in different contexts. Rather than treating various practices of knowledge as rational or irrational in purely scientific terms, it explains the controversies surrounding COVID-19 by drawing on a theoretical framework that recognizes different types of rationality, and hence plural conceptualizations of evidence. Debates within and beyond the medical establishment on the efficacy of measures such as mandatory face masks are examined in detail, as are various degrees of hesitancy towards vaccines. The authors demonstrate that it is ultimately through narratives that knowledge about medical and other phenomena is communicated to others, enters the public space, and provokes discussion and disagreements. This title is also available as Open Access on Cambridge Core.

As one of the first researchers authorised to observe hearings and access court files at the Court of Protection, Jaime Lindsey offers an original account and analysis of the workings of this court. Using data collected with the approval from the senior judiciary of the Court of Protection and the Ministry of Justice, this innovative book combines empirical data with theoretical and normative analysis. It takes a socio-legal approach to understanding how the Mental Capacity Act operates in practice to achieve access to justice and situates current debates within an international context, showing how other jurisdictions have been guided by the United Nations Convention on the Rights of Persons with Disabilities. Furthering scholarship across several fields including access to justice, healthcare law and procedural justice theory, this is a timely and pioneering book that argues for a reimagining of the Court of Protection.

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.

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

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

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.

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 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.

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 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.

The news that the United States tortured prisoners in the war on terror has brought shame to the nation, yet little has been written about the doctors and psychologists at these prisons. In "Oath Betrayed", medical ethics expert and physician Steven H. Miles tells how doctors, psychologists, and medics cleared prisoners for interrogation, advised and monitored abuse, falsified documents - including death certificates - and were largely silent as the scandal unfolded. This updated and expanded paperback edition gives newly uncovered details about the policies that engage clinicians in torture. It discusses the ongoing furor over psychologists' participating in interrogations. Most explosively this new edition shows how interrogation psychologists may have moved from information-gathering to coercive experiments, warning all of us about a new direction in U.S. policy and military medicine - a direction that not so long ago was unthinkable.

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.

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.

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.

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.

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.