As a society, we have learned to value diversity. But can some strategies to achieve diversity mask deeper problems, ones that might require a different approach and different solutions? With "Inclusion," Steven Epstein argues that in the field of medical research, the answer is an emphatic yes.
Formal concern with diversity in American medical research, Epstein shows, is a fairly recent phenomenon. Until the mid-1980s, few paid close attention to who was included in research subject pools. Not uncommonly, scientists studied groups of mostly white, middle-aged men--and assumed that conclusions drawn from studying them would apply to the rest of the population. But struggles involving advocacy groups, experts, and Congress led to reforms that forced researchers and pharmaceutical companies to diversify the population from which they drew for clinical research. That change has gone hand in hand with bold assertions that group differences in society are encoded in our biology--for example, that there are important biological differences in the ways that people of different races and sexes respond to drugs and other treatments.
While the prominence of these inclusive practices has offered hope to traditionally underserved groups, Epstein argues forcefully that it has drawn attention away from the tremendous inequalities in health that are rooted not in biology but in society. There is, for instance, a direct relationship between social class and health status--and Epstein believes that a focus on bodily differences can obscure the importance of this factor. Only when connected to a broad-based effort to address health disparities, Epstein explains, can a medical policy of inclusionachieve its intended effects.
A fascinating history, powerful analysis, and call to action, "Inclusion" will be essential reading for medical professionals, policymakers, and any concerned citizen.

Embryo research, cloning, assisted conception, neonatal care, saviour siblings, organ transplants, drug trials - modern developments have transformed the field of medicine almost beyond recognition in recent decades and the law struggles to keep up. In this highly acclaimed and very accessible book, now in its sixth edition, Margaret Brazier and Emma Cave provide an incisive survey of the legal situation in areas as diverse as fertility treatment, patient consent, assisted dying, malpractice and medical privacy. The book has been fully revised and updated to cover the latest cases, from assisted dying to informed consent; legislative reform of the NHS, professional regulation and redress; European regulations on data protection and clinical trials; and legislation and policy reforms on organ donation, assisted conception and mental capacity. Essential reading for healthcare professionals, lecturers, medical and law students, this book is of relevance to all whose perusal of the daily news causes wonder, hope and consternation at the advances and limitations of medicine, patients and the law. -- .

In this book, Susanne Lundin explores the murky world of organ trade. She tracks exploited farm workers in Moldova, prosecutors in Israel and surgeons in the Philippines. Utilizing unique source material she depicts a rapidly growing organ market characterized by both advanced medical technology and human trafficking.

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

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.

With contributions from: Eric Blyth, Ken Daniels, Julia Feast, Robert Lee, Nina Martin, Alexina McWhinnie, Derek Morgan, Clare Murray, Sharon Pettle, Claire Potter, Jim Richards and Francoise Shenfield

The separation of procreation from conception has broadened notions of parenthood and created novel dilemmas. A woman may carry a foetus derived from gametes neither or only one of which came from her or her partner; or she may carry a foetus created using in vitro fertilisation (IVF) with the purpose of handing it to two other parents one, neither or both of whom may be genetically related to the prospective child. Parents may consist of single-sex couples, only one of them genetically related to the child; the prospective mother may be past her menopause; and genetic parenthood after death is now achievable. In a world increasingly reliant on medical science, how can the argument that equates traditional with natural and novel with unnatural/unethical be justified? Should there be legislation, which is notoriously slow to change, in a field driven by dazzling new possibilities at ever faster rate; particularly when restrictions differ from country to country, so that those who can afford it travel elsewhere for their treatment of choice? Whose rights are paramount - the adults hoping to build a family or the prospective child(ren)s future well being? On what basis can apparently competing rights be regulated or adjudicated and how and to what extent can these be enforced in practice?

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.

The second and thoroughly revised edition of the 1999 reference provides substantially expanded citations in vital areas such as institutional liability, genetics, managed care, integrated delivery systems, professional regulation, and antitrust law. This comprehensive reference work is unique in its scope, accuracy, timeliness, and viability. It is endorsed by the American Health Lawyers Association and the American Hospital Association.

Text, Cases and Materials on Medical Law and Ethics presents a valuable collection of materials relating to often controversial areas of the law. Comprising extracts from statutes, cases and scholarly articles alongside expert author commentary and guidance which signposts the key issues and principles, this book is an ideal companion to this increasingly popular subject. Fully revised, this new edition incorporates expanded content, including: updated coverage of consent and decision making, including the the Montgomery v Lanarkshire Health Board (2015) judgment; the impacts of the EC directive for clinical trials and GDPR on the research use of patient data; and discussion of other recent developments in the case law, including the 2017 Charlie Gard litigation, the 2016 Privy Council decision in Williams v Bermuda on negligence causation, and the UK Supreme Court judgment in A & B v SS for Health (2017) on funding for patients from Northern Ireland seeking terminations elsewhere. Providing a comprehensive and up-to-date resource on this topical area of the law, this textbook is an invaluable reference tool for students of medical law as well as those studying medicine.

Written for practitioners and policymakers, this book will help professionals across health, education, social care and juvenile justice services to understand the needs of young offenders and adolescents at risk of entering the criminal justice system. Developmental in approach, the textbook provides a comprehensive overview of forensic child and adolescent mental health, using cases to help clinicians link theoretical principles to practice and understand how mental health and neurodevelopmental impairment can relate to offending behaviour. With an emphasis on preventive initiatives, early intervention and the building of psycho-social resilience through the delivery of values based practice, this book highlights the need for comprehensive assessment for young people across multiple domains of their lives. This book is of interest to all clinicians working within mental health teams, practitioners working with children and adolescents, professionals involved with youth justice and medico-legal issues, and politicians responsible for establishing health and social policy.

In Health in Ruins Cesar Ernesto Abadia-Barrero chronicles the story of El Materno-Colombia's oldest maternity and neonatal health center and teaching hospital-over several decades as it faced constant threats of government shutdown. Using team-based and collaborative ethnography to analyze the social life of neoliberal health policy, Abadia-Barrero details the everyday dynamics around teaching, learning, and working in health care before, during, and after privatization. He argues that health care privatization is not only about defunding public hospitals; it also ruins rich traditions of medical care by denying or destroying ways of practicing medicine that challenge Western medicine. Despite radical cuts in funding and a corrupt and malfunctioning privatized system, El Materno's professors, staff, and students continued to find ways to provide innovative, high-quality, and noncommodified health care. By tracking the violences, conflicts, hopes, and uncertainties that characterized the struggles to keep El Materno open, Abadia-Barrero demonstrates that any study of medical care needs to be embedded in larger political histories.

Juvenile offending and anti-social behaviour are enormous societal concerns. This broad-reaching volume summarizes the current evidence on prevention, diversion, causes, and rates of delinquency, as well as assessment of risk and intervention needs. A distinguished cast of contributors from law, psychology, and psychiatry describe what we know about interventions in school, community, and residential contexts, focusing particularly on interventions that are risk reducing and cost effective. Equally important, each chapter comments on what is not well supported through research, distinguishing aspects of current practice that are likely to be effective from those that are not and mapping new directions for research, policy, and practice. Finally, the volume provides a description of a model curriculum for training legal and mental health professionals on conducting relevant assessments of adolescents for the courts. Effectively bridging research and practice, this will be an important resource for legal and mental health professionals involved in the juvenile justice system, policy makers seeking humane but effective interventions in the context of society's need for safety, and those involved in teaching about and training in juvenile delinquency.

This easy-to-read book explains the nuts and bolts of the Mental Capacity Act 2005 that clinicians need to understand and use in their daily practice. This Act now gives all clinicians the authority to provide medical care and treatment for people over 16 years of age who lack the capacity to consent for themselves. It covers: how to assess whether a person lacks capacity and how to clarify the threshold of decision-making incapacity; the range, scope and limitations of the various authorities to treat (including 'best interests' decisions, advance decisions and lasting powers of attorney); the range of safeguards in place (such as the Deprivation of Liberty Safeguards (DoLs), the Court of Protection and Independent Mental Health Advocates); and relevant aspects of the Human Rights Act 1998, the Mental Health Act (including all recent amendments) and illustrative case law. There have been numerous developments in case law in the two years since the first edition. The second edition expands on clinically relevant issues from the courts, and assists in bridging the gap between court judgments and the frontline clinician.

Courts recognize that those who are involved in medico-legal proceedings have a stake in the outcome of their psychological assessment, regardless of whether they are high- or low-functioning individuals. Accounting for the validity of the evaluation in low-functioning examinees is frequently made more difficult by impairment; when evaluating testimony from people with intellectual disability (ID), neuropsychologists and psychologists must acknowledge the differences between the medico-legal evaluation and the clinical evaluation. This book provides helpful guidelines for assessing validity in low-functioning claimants. It charts recent advances in psychological and neuropsychological assessment pertaining to civil and criminal proceedings while examining issues such as validity and motivation, assessments of disability, criminal and civil capacities, capital cases, Miranda waiver cases, and others. In disability cases, the Social Security Administration has had a long-standing policy that prevents neuropsychologists and psychologists from using validity instruments-yet, using this book, an accurate and valid assessment can still be obtained. Evaluators who perform assessments in capital cases will find up-to-date discussions of the Flynn Effect, measurement of intellectual functioning, problems associated with the assessment of adaptive functioning, and the challenge of validity assessment. Miranda waiver evaluations for those with low IQ are discussed concerning issues of capacity measurement, including reading and language analysis for the Miranda advisement in the particular jurisdiction in question. Testamentary capacity is discussed at length, showing how understanding of the legal standard is helpful in guiding the examination. Competency to stand trial, or adjudicative competence, is the main topic in the area of criminal competencies, with exploration of the Dusky standard and the various tests used to evaluate this competence, focusing on individuals with ID.

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. As the number of malpractice cases continues to grow, radiologists will become increasingly involved in litigation. The aetiology of radiological error is multi-factorial. This book focuses on (1) some medico-legal aspects inherent to radiology (radiation exposure related to imaging procedures and malpractice issues related to contrast media administration are discussed in detail) and on (2) the spectrum of diagnostic errors in radiology. Communication issues between the radiologists and physicians and between the radiologists and patients are also presented. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation.

Reproductive donation is the most contentious area of assisted reproduction. Even within Europe there are wide variations in what is permitted in each country. This multi-disciplinary book takes a fresh look at the practices of egg, sperm and embryo donation and surrogacy, bringing together ethical analysis and empirical research. New evidence is offered on aspects of assisted reproduction and the families these create, including non-traditional types. One of the key issues addressed is should children be told of their donor origin? If they do learn the identity of their donor, what kinds of relationships may be forged between families, the donor and other donor sibling families? Should donation involve a gift relationship? Is intra-familial donation too close for comfort? How should we understand the growing trend for 'reproductive tourism'? This lively and informed discussion offers new insights into reproductive donation and the resulting donor families.

Patient safety is an issue which in recent years has grown to prominence in a number of countries' political and health service agendas. The World Health Organisation has launched the World Alliance for Patient Safety. Millions of patients, according to the Alliance, endure prolonged ill-health, disability and death caused by unreliable practices, services, and poor health care environments. At any given time 1.4 million people worldwide are suffering from an infection acquired in a health facility. Patient Safety, Law Policy and Practice explores the impact of legal systems on patient safety initiatives. It asks whether legal systems are being used in appropriate ways to support state and local managerial systems in developing patient safety procedures, and what alternative approaches can and should be utilized. The chapters in this collection explore the patient safety managerial structures that exist in countries where there is a developed patient safety infrastructure and culture. The legal structures of these countries are explored and related to major in-country patient safety issues such as consent to treatment protocols and guidelines, complaint handling, adverse incident reporting systems, and civil litigation systems, in order to draw comparisons and conclusions on patient safety.

Japan is the fastest aging country, with the largest super-aged society in the world and growing larger by the day, yet its universal health care costs are relatively low. In Health Insurance Politics in Japan, Takakazu Yamagishi draws back the curtain for an international audience and investigates how Japan has been able to control health care costs through health insurance politics. Covering the period from the Meiji Restoration to the Abe Administration, Yamagishi uses a historical institutionalist approach to examine the driving force behind the development of health insurance policies in Japan. Yamagishi pays special attention to the roles of government and medical professionals, the main actors of the policymaking and medical worlds, in this development. Health Insurance Politics in Japan pushes Japan into the spotlight of the international conversation about health care reform.

Everyone seeks to avoid getting into a lawsuit, but what do you do if this does happen?

Getting sued for medical malpractice is one of the most traumatic events of a physician's career.

This text will guide doctors and physicians through the process from the moment they receive a summons until the after-trial appeal process.Containing valuable information that physicians need to know to prevent making critical mistakes that can hurt their caseWith strategies explained to maximize their chances of a defendant's verdict.Including vital information on how to change your attorney, act at the deposition and dress for court,

Navigating through what is a mysterious and terrifying process in non-legalese language that is easy to understand including what makes patients angry, strategies for coping, sample questions and tips on answering them to what happens in court and how to continue if there is a bad outcome.

As America debates the merits of government-provided health insurance, it is important to note that the U.S. government is already the largest insurance provider in the world. For decades, it has used taxpayer funds to support the world's largest health care insurance programs (Medicare and Medicaid) as well as the biggest pension and disability insurance system (Social Security). The recent economic crisis has prompted the government to dramatically increase its insurance role by assuming large equity positions in private firms and bailing out troubled mortgages buyers and sellers. Do these public insurance programs improve social welfare? Or does government intervention risk moral hazard and result in inefficient programs that would be better handled by the private sector? In Public Insurance and Private Markets, leading economists critically examine the government's role in insuring against pension fund shortfalls, crop losses, property damage from floods and other natural catastrophes, bank failure, and terrorism. Jeffrey R. Brown and his coauthors argue that government intervention must always be economically justified; that risk adjusted premiums are essential; that the true taxpayer burden for public insurance programs must be recognized; and that private markets are capable of transferring risk without government intervention. Poorly designed government insurance programs result in misallocation of resources, excessive risk-taking, and potentially enormous burdens on current and future taxpayers. Public Insurance and Private Markets offers market-based guidelines for the proper scope of government intervention and the design of public insurance programs guidelines that will benefit the U.S. economy and protect the resources of future generations.

Deficiencies and shortfalls in the supply of human organs for transplantation and human tissue for research generate policy dilemmas across the world and have often given rise to major and deleterious controversies, such as those relating to organ and tissue retention practices following post-mortem examination. They also create an environment in which illegitimate commercial activities flourish. At the same time, patients are denied the therapy they desperately require and researchers are impeded from carrying out vital work into the causes of, and efficacious treatments for, major illnesses and diseases. David Price sets out a clear and integrated legal and policy framework which emanates from the tissue source but protects the interests of donors and relevant professionals through tailored property entitlements, but without presupposing rights to trade in 'original' materials.

This easy-to-read reference book provides a practical approach for dealing with the legal and regulatory compliance issues involved in human research. Covering a broad range of topics, such as consent, confidentiality, subject recruitment and selection, the role of the investigator and Institutional Review Board, it offers timely and useful strategies for achieving regulatory compliance while reducing liability. In addition, insurance, quality management, accreditation, and risk management are topics examined in the book. The practical insights found in this volume are not found in other books on the subject. Clinical Trials and Human Research is a practical tool to help anyone involved in clinical research.

Written by an MD/JD, this book offers a unique perspective on medical-legal issues surrounding daily clinical practice. It covers all the essentials and tells the inside secrets of how to avoid cases that cost the medical community millions each year. Readers will learn basic law and the ways laws are interpreted. In addition, the book focuses on the law-medicine-politics triangle and its effect on physicians, the impact of and issues related to diversity in medical malpractice, and other essential topics. Physicians who better understand malpractice laws are better clinical decision makers who feel more confident in their ability as doctors.

This groundbreaking volume is the first to analyze how and to what extent bioethics considerations influence today's judges. Previous books have attended to the law that governs bioethics problems, but this is the first to examine when and how bioethical issues impact judicial reasoning and decision-making. The volume examines the cutting-edge of the relationship of bioethics to law, and explores how law receives, assesses, and uses bioethics.

Noise damage to hearing health is a health risk, which is associated with both civilian and military occupations as well as certain leisure activities. Occupational noise damage to hearing must date from the Bronze Age, when man first began to fashion metals some five thousand years ago. The rapid growth of industrialisation over the past two centuries has produced what might be termed as the current civilian epidemic of occupational noise induced hearing loss. This series seeks to address points relevant to current knowledge of the subject. The volume should prove useful to members of the many disciplines that have an interest in this subject.