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.

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.

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.

A recent Harris Poll revealed some disturbing aspects of the current state of health care provision for women and children. The poll dealt with issues as diverse as clincial examinations and communication between women and their doctors. Such issues, long ignored or under-appreciated by medical researchers, clinicians, and public policy makers, are increasingly receiving attention, not only from public health experts, but also from politicians, pressure groups, and the media. Reproductive Health Care for Women and Babies addresses all the medical and societal aspects of health care that go to form public health policy for women. The editors have assembled an international team of contributors who provide the reader with a truly global picture of the issues involved. These features combine to provide a much better understanding of the health care needs of women. Doctors will be able to take a broader view of their role, beyond the traditional one of diagnosis and treatment, and allow to communicate more effectively their individual and collective views. Such a reorientation is essential if physicians are to assume their proper role at the centre of the formation of public health policy. For anybody involved in providing health care for women and children this book is essential reading.

If a competent adult refuses medical treatment, physicians and public officials must respect her decision. Coercive medical paternalism is a clear violation of the doctrine of informed consent, which protects patients' rights to make medical decisions even if a patient's choice endangers her health. The same reasons for rejecting medical paternalism in the doctor's office are also reasons to reject medical paternalism at the pharmacy, yet coercive medical paternalism persists in the form of premarket approval policies and prescription requirements for pharmaceuticals. In Pharmaceutical Freedom Jessica Flanigan defends patients' rights of self-medication. Flanigan argues that public officials should certify drugs instead of enforcing prohibitive pharmaceutical policies that disrespect people's rights to make intimate medical decisions and prevent patients from accessing potentially beneficial new therapies. This argument has revisionary implications for important and timely debates about medical paternalism, recreational drug legalization, human enhancement, prescription drug prices, physician assisted suicide, and pharmaceutical marketing. The need for reform is especially urgent as medical treatment becomes increasingly personalized and patients advocate for the right to try. The doctrine of informed consent revolutionized medicine in the twentieth century by empowering patients to make treatment decisions. Rights of self-medication are the next step.

This handbook is a thorough and state of the art overview of a central and fast-growing topic making it the ideal reference source for both students and scholars Essential reading for students and researchers in political philosophy, bioethics, public health ethics, or philosophy of medicine. The handbook will also be very useful for those in related fields, such as medicine and public health This is the only handbook to pull together a thoroughly comprehensive overview of the topic of the philosophy of public health. This handbook will help the field of study organise itself into a proper subject: it will be a rallying point for any student and researcher interested in the subject All chapters are specially commissioned, written by an international team of renowned contributors.

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. asdf

This book offers a theoretical and practical overview of the specific ethical and legal issues in pediatric organ transplantation. Written by a team of leading experts, Ethical Issues in Pediatric Organ Transplantation addresses those difficult ethical questions concerning clinical, organizational, legal and policy issues including donor, recipient and allocation issues. Challenging topics, including children as donors, donation after cardiac death, misattributed paternity, familial conflicts of interest, developmental disability as a listing criteria, small bowel transplant, and considerations in navigating the media are discussed. It serves as a fundamental handbook and resource for pediatricians, transplant health care professionals, trainees, graduate students, scholars, practitioners of bioethics and health policy makers.

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.

This book presents an interpretation of pharmaceutical, surgical and psychotherapeutic interventions based on a univalent metalanguage: biosemiotics. It proposes that a metalanguage for the physical, mental, social, and cultural aspects of health and medicine could bring all parts and aspects of human life together and thus shape a picture of the human being as a whole, made up from the heterogeneous images of the vast variety of sciences and technologies in medicine discourse. The book adopts a biosemiotics clinical model of thinking because, similar to the ancient principle of alchemy, tam ethice quam physice, everything in this model is physical as much as it is mental. Signs in the forms of vibrations, molecules, cells, words, images, reflections and rites conform cultural, mental, physical, and social phenomena. The book decodes healing, dealing with health, illness and therapy by emphasizing the first-person experience as well as objective events. It allows readers to follow the energy-information flows through and between embodied minds and to see how they form physiological functions such as our emotions and narratives.

Synthetic biology is a dynamic, young, ambitious, attractive, and heterogeneous scientific discipline. It is constantly developing and changing, which makes societal evaluation of this emerging new science a challenging task, prone to misunderstandings. Synthetic biology is difficult to capture, and confusion arises not only regarding which part of synthetic biology the discussion is about, but also with respect to the underlying concepts in use. This book offers a useful toolbox to approach this complex and fragmented field. It provides a biological access to the discussion using a 'layer' model that describes the connectivity of synthetic or semisynthetic organisms and cells to the realm of natural organisms derived by evolution.Instead of directly reviewing the field as a whole, firstly our book addresses the characteristic features of synthetic biology that are relevant to the societal discussion. Some of these features apply only to parts of synthetic biology, whereas others are relevant to synthetic biology as a whole. In the next step, these new features are evaluated with respect to the different areas of synthetic biology. Do we have the right words and categories to talk about these new features? In the third step, traditional concepts like "life" and "artificiality" are scrutinized with regard to their discriminatory power. This approach may help to differentiate the discussion on synthetic biology. Lastly our refined view is utilized for societal evaluation. We have investigated the public views and attitudes to synthetic biology. It also includes the analysis of ethical, risk and legal questions, posed by present and future practices of synthetic biology.This book contains the results of an interdisciplinary research project and presents the authors' main findings and recommendations. They are addressed to science, industry, politics and the general public interested in this upcoming field of biotechnology.

This book is an ethnographic work that uses a critical medical anthropology approach to examine the concept of fever care in the context of southern India. Through a study of fevers, the study provides a critical overview to medical practice itself, as it is said that the history of fevers is also the history of medicine. This association between fevers and medicine is as relevant today, as this in-depth study of fever care reveals. Acknowledging the central role of health institutions in creating and propagating notions about illness in society, the author examines fever care through a study of hospitals. The study examines various discourses on fevers prevalent in the southern state of Kerala, which influence policy and programmatic dimensions of the state health services system. Fever care implies those aspects related to provisioning and cost involved among public and private sector hospitals. A second and more important dimension of this book is a critique of the culture of biomedical practice, informed by the social constructivist framework and approaches in the field of science studies. Overall, the book studies the processes by which physical symptoms like fever are treated as epidemics to be controlled, and are therefore brought within a biomedical system, thereby opening up options for commercialization of care.

This book offers a comprehensive and unitary study of the philosophy of Francis Bacon, with special emphasis on the medical, ethical and political aspects of his thought. It presents an original interpretation focused on the material conditions of nature and human life. In particular, coverage in the book is organized around the unifying theme of Bacon's notion of appetite, which is considered in its natural, ethical, medical and political meanings. The book redefines the notions of experience and experiment in Bacon's philosophy of nature, shows the important presence of Stoic themes in his work as well as provides an original discussion of the relationships between natural magic, prudence and political realism in his philosophy. Bringing together scholarly expertise from the history of philosophy, the history of science and the history of literature, this book presents readers with a rich and diverse contextualization of Bacon's philosophy.

The process of health care reforms must be based on demographic, epidemiological and economic evidence if it is to achieve the fundamental target of affordable, sustainable and efficient health care services for the entire population. Consequently, costing of health care services has become a frequently used element of health care reforms. This book presents the essentials of costing in a health economic framework and gives examples from successful costing studies done by the author in Tanzania, Vietnam and Burkina Faso. Based on these examples it demonstrates the importance of costing information for the planning and decision-making process in the field of budgeting, resource allocation, setting an insurance premium and strategic planning. The main message of this book is that costing of health care services is a valuable instrument in the fight for better 'health for all'.

Touch may well be one of the least understood or talked about subjects in the helping professions. A discussion on the importance and ethics of positive, caring, and appropriate touch in professions such as teaching, nursing and counselling is long overdue. Touch in the Helping Professions delivers just that, weaving together scholarly evidence, research and clinical practice from a wide range of perspectives encompassing philosophy, theology, psychology, and anthropology to challenge assumptions about the role of touch in the helping professions. The contributors to the volume focus not only on the overarching roles of gender, age, culture and life experience, but go beyond to encompass canine-assisted therapy, touch deprivation, sacred objects, as well as key ethical considerations. The prevailing lack of dialogue, due to fear of contravening ethical boundaries, has stood in the way of an open and responsible discussion on the use of touch in therapy. Touch in the Helping Professions is a welcome and much needed contribution to the field-a window onto a fundamental need. This book is published in English. - Cet ouvrage offre un ensemble de donnees probantes et de resultats cliniques a l'appui du toucher dans le developpement physique et emotionnel. Il est structure selon trois axes : la theorie sur le toucher; la pratique du toucher dans un contexte de therapie, et les questions ethiques. Il aborde la question du role du genre, de l'age, de la culture et de l'experience de vie, des sujets comme la zootherapie, la privation sensorielle, des objets sacres, et des considerations d'ordre ethique. Les approches variees - philosophie, theologie, psychologie, anthropologie - remettent en question les presuppositions, offrent un contexte historico-culturelprofessionnel, et font appel a des donnees primaires. Les collaborateurs soutiennent que le toucher sain et non sexuel n'est pas suffisamment enseigne dans le cadre de la formation professionnelle. Cette absence de dialogue - engendree par la crainte de depasser des bornes ethiques, fait en sorte qu'une discussion ouverte et responsable sur l'utilisation du toucher dans un cadre therapeutique ne peut avoir lieu, alors meme qu'elle contribuerait aux balises theoriques de notre comprehension de cet enjeu fondamental. Ce livre est publie en anglais.

Biotech Juggernaut: Hope, Hype, and Hidden Agendas of Entrepreneurial BioScience relates the intensifying effort of bioentrepreneurs to apply genetic engineering technologies to the human species and to extend the commercial reach of synthetic biology or "extreme genetic engineering." In 1980, legal developments concerning patenting laws transformed scientific researchers into bioentrepreneurs. Often motivated to create profit-driven biotech start-up companies or to serve on their advisory boards, university researchers now commonly operate under serious conflicts of interest. These conflicts stand in the way of giving full consideration to the social and ethical consequences of the technologies they seek to develop. Too often, bioentrepreneurs have worked to obscure how these technologies could alter human evolution and to hide the social costs of keeping on this path. Tracing the rise and cultural politics of biotechnology from a critical perspective, Biotech Juggernaut aims to correct the informational imbalance between producers of biotechnologies on the one hand, and the intended consumers of these technologies and general society, on the other. It explains how the converging vectors of economic, political, social, and cultural elements driving biotechnology's swift advance constitutes a juggernaut. It concludes with a reflection on whether it is possible for an informed public to halt what appears to be a runaway force.

This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient. The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK. Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved.

With the advances of medicine, questions of medical ethics have become more urgent and are now considered of great social and political significance. An innovatively designed, activity-based workbook, this text was prepared using papers and case studies collected from several countries in the European Union. It reflects the issues and concerns that confront clinical practitioners throughout Europe and elsewhere today and presents varying national responses in law and policy to these concerns, as identified by ethicists, lawyers, theologians and practitioners. The problems they examine include the relationship between medical research and medical practice, elementary regulations of medical research, the complexity of informed consent, and the role of the sponsor or scientific community.

'How to be Good?' is the pre-eminent question for ethics, although one that philosophers and ethicists seldom address head on. Knowing how to be good, or perhaps (more modestly and more accurately) knowing how to go about trying to be good, and the ways in which it is pointless or self-defeating to try to be good, is of immense theoretical and practical importance. And what goes for trying to be good oneself, goes also for trying to provide others with ways of being good, and for trying to make them good whether they like it or not. This is what is meant by 'moral enhancement'. There are many proposed methodologies or technologies for moral enhancement. Some of them are ancient and/or familiar: we may attempt moral enhancement by setting a good example, by good parenting, by education or training, by peer pressure, by telling stories with a moral, in words or in pictures, and so on. We can imbibe substances with mood changing or motivational effects. We can also use medical, biological, or other scientific means; we can search for and deploy chemicals, or biological or molecular agents, which we believe will change people for the better; and we can modify the environment to make bad outcomes of all sorts less likely. We can experiment with political and social systems, institutions, and arrangements designed to make the world a better place or people better people. The question whether and to what extent moral enhancement is possible is the subject of this book.

Case law evidence shows that mental health professionals (MHPS) have lost cases in court because they based their professional action on the wrong definition of legal or ethical terminology. Many have also been sanctioned or their license revoked because of professional actions arising from a lack of clear understanding of these terminologies. This dictionary confronts this problem by providing MHPS with clear, concise, and functional definitions of many legal and ethical terminologies. A review of the meaning of these terms before a professional action or activity is sure to enhance compliance with ethical and legal standards and regulations. The addresses and phone numbers of state licensure boards for counselors, psychologists and social workers are included to facilitate consultation in related issues not specifically covered by definitions.

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

Privacy is an unwieldy concept that has eluded an essentialised definition despite its centrality and importance in the body of bioethics. The compilation presented in this volume represents continuing discussions on the theme of privacy in the context of genetic information. It is intended to present a wide range of expert opinion in which the notion of privacy is examined from many perspectives, in different contexts and imperatives, and in different societies, with the hope of advancing an understanding of privacy through the examination and critique of some of its evolving component concepts such as notions of what constitute the personal, the context of privacy, the significance and impact of the relational interests of others who may share the same genetic inheritance, and mechanisms for the protection of privacy (as well as of their limitations), among others. More specifically, the discussions in this volume encourages us to think broadly about privacy, as encompassing values that are entailed in the sociality of context and of relations, and also as freedom from illegitimate and excessive surveillance. A long-standing question that continues to challenge us is whether genetic information should be regarded as exceptional, as it is often perceived. A conclusion that could be derived from this volume is that while genetic information may be significant, it is not exceptionally so. The work presented in this volume underlines the continuing and growing relevance of notions of privacy to genomic science, and the need to take ownership of a genetic privacy for the future through broad, rigorous and open discussion.Contributors: Alastair V Campbell, Benjamin Capps, Jacqueline JL Chin, Oi Lian Kon, Kenji Matsui, Thomas H Murray, Nazirudin Mohd Nasir, Dianne Nicol, Anh Tuan Nuyen, Onora O'Neill, Margaret Otlowski, Yvette van der Eijk, Chunshui Wang, Ross S White.

This book is designed to present an overview of common geriatrics ethical issues that arise during patient care and research activities. Each chapter includes a case example and practical learning pearls that are useful in day-to-day patient care. Coverage includes a brief overview of geriatric epidemiology, highlighting the high rates of dementia, use of surrogate decisions makers at the end-of-life, relocation from home to long-term care facilities, and low health literacy in the geriatrics population. Sections are devoted to issues around capacity, surrogate decision making, end-of-life care, hemodialysis in the elderly, and futility as well as challenges presented by independence questions, such as dementia care, driving, feeding, and intimacy in nursing homes. The text also addresses questions around recognizing, reporting, and treating elder abuse and self-neglect, ethics related to research and technology in the geriatric population, and the use of e-mail, Facebook, and open notes. Written by experts in the field, Ethical Considerations and Challenges in Geriatrics is a valuable tool for trainees at a variety of levels including medical students, residents, and fellows. In addition, it provides practical guidance and a useful reference for practicing geriatricians, primary care physicians, geriatric nurses, social workers, nursing home workers, hospice care employees, and all medical health professionals working with the elderly.

This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical ethics consultants can draw methods and strategies for effectively delivering ethics consultation.