This volume contains the proceedings of the 10th International Symposium on Circumcision, Genital Integrity, and Human Rights. Authors are international experts in their fields, and the book contains the most up-to-date information on the issue of genital cutting of infants and children from medical, legal, bioethical, and human rights perspectives.

Freud promised his patients absolute confidentiality, regardless of what they revealed, but privacy in psychotherapy began to erode a half-century ago. Psychotherapists now seem to serve as "double agents" with a dual and often conflicting allegiance to patient and society. Some therapists even go so far as to issue Miranda-type warnings, advising patients that what they say in therapy may be used against them. Confidentiality and Its Discontents explores the human stories arising from this loss of confidentiality in psychotherapy. Addressing different types of psychotherapy breaches, Mosher and Berman begin with the the story of novelist Philip Roth, who was horrified when he learned that his psychoanalyst had written a thinly veiled case study about him. Other breaches of privacy occur when the so-called duty to protect compels a therapist to break confidentiality by contacting the police. Every psychotherapist has heard about "Tarasoff," but few know the details of this story of fatal attraction. Nor are most readers familiar with the Jaffee case, which established psychotherapist-patient privilege in the federal courts. Similiarly, the story of Robert Bierenbaum, a New York surgeon who was brought to justice fifteen years after he brutally murdered his wife, reveals how privileged communication became established in a state court. Meanwhile, the story of New York Chief Judge Sol Wachtler, convicted of harassing a former lover and her daughter, shows how the fear of the loss of confidentiality may prevent a person from seeking treatment, with potentially disastrous results. While affirming the importance of the psychotherapist-patient privilege, Confidentiality and Its Discontents focuses on both the inner and outer stories of the characters involved in noteworthy psychotherapy breaches and the ways in which psychiatry and the law can complement but sometimes clash with each other.

This book addresses the debate usually tagged as being about 'markets in human body parts' which is antagonistically divided into pro-market and anti-market positions. The author provides a set of propositions about how to approach this and shows a way out of the concrete impasse of it. Assumptions about markets and bodies that characterize this debate are analyzed and described while the author argues that these assumptions are in fact constitutive for exchanges of human bodily material - but in unacknowledged ways. It is concluded that what we need is a different analytical approach to better understand the mechanisms at play when organizations exchange organs, tissues and cells for use in transplantation and fertility medicine.

After the young South African athlete Caster Semenya won the 800m title at the 2009 World Championships she was obliged to undergo gender testing and was temporarily withdrawn from international competition. The way that this controversy unfolded represents a rich and multi-layered example of the construction of gender in wider society and the interrelationships between sport, culture and the media. This is the first book to explore the case in depth, from socio-cultural, ethical and legal perspectives. Analysing what came to be called "the Caster Semenya Case" in a comprehensive and multi-disciplinary fashion, and covering issues from media discourses and the rhetoric and regulations of the sport's governing bodies to the reaction of the athlete herself, the book explores the ethics of how gender norms in sport, and in society more generally, are constructed through appearance, behaviour and sporting performance. This 2009 controversy can be taken as an indicator of the tensions of the time, and served as a link between medical sciences, society and gender. Including discussions of key concepts such as 'intersex', 'body norms', and 'fairness', Gender Testing in Sport is fascinating and important reading for anybody with an interest in sport studies, gender studies or biomedical ethics.

Who should define what constitutes ethical and lawful medical practice? Judges? Doctors? Scientists? Or someone else entirely? This volume analyses how effectively criminal law operates as a forum for resolving ethical conflict in the delivery of health care. It addresses key questions such as: how does criminal law regulate controversial bioethical areas? What effect, positive or negative, does the use of criminal law have when regulating bioethical conflict? And can the law accommodate moral controversy? By exploring criminal law in theory and in practice and examining the broad field of bioethics as opposed to the narrower terrain of medical ethics, it offers balanced arguments that will help readers form reasoned views on the ethical legitimacy of the invocation and use of criminal law to regulate medical and scientific practice and bioethical issues.

This book covers the new field of healthcare organization ethics from theory to practical application. It can be used as a text for courses on the subject, as a reference for those interested in the present status of the field, and as a practical guide for healthcare executives, clinicians and committee members who are beginning to develop an organizational ethics program for their institution.

The manner in which genetic research associated with addiction is conducted, interpreted and translated into clinical practice and policy initiatives raises important social, ethical and legal issues. Genetic Research on Addiction fulfils two key aims; the first is to identify the ethical issues and requirements arising when carrying out genetically-based addiction research, and the second is to explore the ethical, legal and public policy implications of interpreting, translating and applying this research. The book describes research guidelines on human protection issues such as improving the informed consent process, protecting privacy, responsibilities to minors and determining whether to accept industry funding. The broader public health policy implications of the research are explored and guidelines offered for developing effective social interventions. Highly relevant for clinicians, researchers, academics and policy-makers in the fields of addiction, mental health and public policy.

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

Since the 1970s, we have witnessed astonishing scientific and technical progress in the field of organ transplantation. Patients who suffer organ failure can now often have their lives greatly improved both in terms of quality and quantity of years. The success of transplantation techniques has created an enormous demand for donor organs. Unfortunately, donor organs are in short supply, relative to the number of patients who could greatly benefit from them. Therefore, donor organs are a scarce and valuable resource that must be thoughtfully and fairly allocated among waiting patients. Not surprisingly, this situation raises many pressing ethical questions, each requiring careful consideration. This volume presents a systematic and balanced treatment of some of the most pressing ethical questions including: what is our ethical obligation to become organ donors and who should be allowed to donate?; to what extent can markets facilitate the fair allocation of organs and how should we most fairly determine who should be recipients?; how do we determine death when the donor is not brain dead?; should non-human donor organs be used to save human lives and should we use organs from anencephalic infants and tissue from embryos? ; and what is the role of the news media in covering stories about organ transplantation? Many of the leading authorities in medical ethics come together in this volume to develop extensive analyses and arguments. The reader is provided with a sound understanding of the ethical, as well as many of the broader issues in organ donation and transplantation.

The metaphor of the monster or predator-usually a sexual predator, drug dealer in areas frequented by children, or psychopathic murderer-is a powerful framing device in public discourse about how the criminal justice system should respond to serious violent crimes. The cultural history of the monster reveals significant features of the metaphor that raise questions about the extent to which justice can be achieved in both the punishment of what are regarded as "monstrous crimes" and the treatment of those who commit such crimes. This book is the first to address the connections between the history of the monster metaphor, the 19th century idea of the criminal as monster, and the 20th century conception of the psychopath: the new monster. The book addresses, in particular, the ways in which the metaphor is used to scapegoat certain categories of crimes and criminals for anxieties about our own potential for deviant, and, indeed, dangerous interests. These interests have long been found to be associated with the fascination people have for monsters in most cultures, including the West. The book outlines an alternative public health approach to sex offending, and crime in general, that can incorporate what we know about illness prevention while protecting the rights, and humanity, of offenders. The book concludes with an analysis of the role of forensic psychiatrists and psychologists in representing criminal defendants as psychopaths, or persons with certain personality disorders. As psychiatry and psychology have transformed bad behavior into mad behavior, these institutions have taken on the legal role of helping to sort out the most dangerous among us for preventive "treatment" rather than carceral "punishment."

Why is death bad for us, even on the assumption that it involves the absence of experience? Is it worse for us than prenatal nonexistence? Kamm begins by considering these questions, critically examining some answers other philosophers have given. She explores in detail suggestions based on our greater concern over the loss of future versus past goods and those based on the insult to persons which death involves. In the second part, Kamm deals with the question, "Whom should we save from death if we cannot save everyone?" She considers whether and when the numbers of lives we can save matter in our choice, and whether the extra good we achieve if we save some lives rather than others should play a role in deciding whom to save. Issues such as fairness, solidarity, the role of random decision procedures, and the relation between subjective and objective points of view are discussed, with an eye to properly incorporating these into a nonconsequentialist ethical theory. In conclusion, the book examines specifically what differences between persons are relevant to the distribution of any scarce resource, discussing for example, the distribution (and acquisition) of bodily organs for transplantation. Kamm provides criticism of some current procedures for distribution and acquisition of a scarce resource and makes suggestions for alternatives.

In Better than Human?, noted bioethicist Allen Buchanan grapples with the ethical dilemmas of the medical revolution now upon us. Biomedical enhancements, he writes, can make us smarter, have better memories, be stronger, quicker, have more stamina, live much longer, be more resistant to disease and to the frailties of aging, and enjoy richer emotional lives. They can even improve our character, or at least strengthen our powers of self-control. In spite of the benefits that biomedical enhancements may bring, many people instinctively reject them. Some worry that we will lose something important-our appreciation for what we have or what makes human beings distinctively valuable. To think clearly about enhancement, Buchanan argues, we have to acknowledge that nature is a mixed bag and that our species has many "design flaws". We should be open to the possibility of becoming better than human, while never underestimating the risk that our attempts to improve may backfire.

Research using genetic data raises various concerns relating to privacy protection. Many of these concerns can also apply to research that uses other personal data, but not with the same implications for failure. The norms of exclusivity associated with a private life go beyond the current legal concept of personal data to include genetic data that relates to multiple identifiable individuals simultaneously and anonymous data that could be associated with any number of individuals in different, but reasonably foreseeable, contexts. It is the possibilities and implications of association that are significant, and these possibilities can only be assessed if one considers the interpretive potential of data. They are missed if one fixates upon its interpretive pedigree or misunderstands the meaning and significance of identification. This book demonstrates how the public interest in research using genetic data might be reconciled with the public interest in proper privacy protection.

Legal and ethical competence is a cornerstone of professional midwifery practice and an essential part of midwifery training. Law and Ethics for Midwifery is a unique and practical resource for student midwives. Written by an experienced midwifery lecturer, this text draws on a wide variety of real life case studies and focuses particularly on the core areas of accountability, autonomy and advocacy. Opening with two chapters providing overviews respectively of ethical theories and legislation, the book is then arranged thematically. These chapters have a common structure which includes case studies, relevant legislation, reflective activities and a summary, and they run across areas of concern from negligence through safeguarding to record-keeping. Grounded in midwifery practice, the text enables student midwives to consider and prepare for ethical and legal dilemmas they may face as midwives in clinical practice.

Those involved in end-of-life decision making must take into account both legal and ethical issues. This book starts with a critical reflection of ethical principles including ideas such as moral status, the value of life, acts and omissions, harm, autonomy, dignity and paternalism. It then explores the practical difficulties of regulating end-of-life decisions, focusing on patients, healthcare professionals, the wider community and issues surrounding 'slippery slope' arguments. By evaluating the available empirical evidence, the author identifies preferred ways to regulate decisions and minimise abuses at the end of life, and outlines an ethical theory which can provide practical guidance for those engaged in end-of-life decisions.

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.

John Coggon argues that the important question for analysts in the fields of public health law and ethics is 'what makes health public?' He offers a conceptual and analytic scrutiny of the salient issues raised by this question, outlines the concepts entailed in, or denoted by, the term 'public health' and argues why and how normative analyses in public health are inquiries in political theory. The arguments expose and explain the political claims inherent in key works in public health ethics. Coggon then develops and defends a particular understanding of political liberalism, describing its implications for critical study of public health policies and practices. Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health.

Human information and communication technology (ICT) implants have developed for many years in a medical context. Such applications have become increasingly advanced, in some cases modifying fundamental brain function. Today, comparatively low-tech implants are being increasingly employed in non-therapeutic contexts, with applications ranging from the use of ICT implants for VIP entry into nightclubs, automated payments for goods, access to secure facilities and for those with a high risk of being kidnapped. Commercialisation and growing potential of human ICT implants have generated debate over the ethical, legal and social aspects of the technology, its products and application. Despite stakeholders calling for greater policy and legal certainty within this area, gaps have already begun to emerge between the commercial reality of human ICT implants and the current legal frameworks designed to regulate these products. This book focuses on the latest technological developments and on the legal, social and ethical implications of the use and further application of these technologies.

The sixth edition of the Manual for Research Ethics Committees was first published in 2003, and is a unique compilation of legal and ethical guidance which will prove useful for members of research ethics committees, researchers involved in research with humans, members of the pharmaceutical industry and students of law, medicine, ethics and philosophy. Presented in a clear and authoritative form, it incorporates the key legal and ethical guidelines and specially written chapters on major topics in bioethics by leading academic authors and practitioners, pharmaceutical industry associations and professional bodies.

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rivaltheories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg.

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem - injury caused by a physician - and argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections.