aCahn explores the relationships that underpin artificial reproductive technology: parenting, donating, and becoming (those who are the children brought to life through this process). . . . Much about assisted reproduction are the relationships that are fostered and challenged by the use of the technology, whether donor to potential parent, potential parent to state, surrogate to intended mother, or embryo to clinic, and after it is all adone, a child to parent.a
--Michele Goodwin, author of "Black Markets: The Supply and Demand of Body Parts"

The birth of the first test tube baby in 1978 focused attention on the sweeping advances in assisted reproductive technology (ART), which is now a multi-billion-dollar business in the United States. Sperm and eggs are bought and sold in a market that has few barriersto its skyrocketing growth. While ART has been an invaluable gift to thousands of people, creating new families, the use of someone elseas genetic material raises complex legal and public policy issues that touch on technological anxiety, eugenics, reproductive autonomy, identity, and family structure. How should the use of gametic material be regulated? Should recipients be able to choose the abesta sperm and eggs? Should a child ever be able to discover the identity of her gamete donor? Who can claim parental rights?

Naomi R. Cahn explores these issues and many more in Test Tube Families, noting that although such questions are fundamental to the new reproductive technologies, there are few definitive answers provided by the law, ethics, or cultural norms. The regulatory void outside of minimal requirements for gametic testing and limited protection against deceptivemarketing techniques used by fertility clinics creates thorny problems for all involved in the egg and sperm business.

As a new generation of adonor kidsa comes of age, Test Tube Families calls for better regulation of ART. It exhorts legal and policy-making communities to cease applying piecemeal laws and instead create laws that sustain the fertility industry, yet protect the interests of donors, recipients, and the children that result from successful transfers.

Incorporating real-life stories to illustrate her arguments, Cahn provides specific suggestions for legal reforms. The book sets out a series of controversial proposals, including an end to donor anonymity and a plea for states to clarify parentage decisions. She also calls for the federal government to regulate ART processes to ensure that donors are adequately protected against exploitation, that recipients receive the gametes they have been promised, and that the market functions ethically as well as efficiently.

Kapp's annotated list of 617 titles, in 13 sections, focuses on sources that discuss the `identifiable body of law concerned with personal and institutional relationships, implicated by the delivery of health care for the elderly.' This work is meant for health professionals, attorneys, researchers, educators, and advanced students. The succinct yet informative annotations cover references from January 1, 1980, to August 31, 1987. . . . Highly recommended. Choice Legal questions relating to health care for the elderly have grown increasingly numerous and complex. While these issues have been dealt with extensively by researchers and professional specialists, the literature has grown so vast in the past decade that it is difficult to keep abreast of legal developments. This bibliography is designed to assist practicing health, human services, and legal professionals as well as researchers, teachers, and students in identifying and evaluating information sources that will provide essential guidance on the legal implications of health care for the elderly. Organized in thirteen subject sections, the volume contains more than six-hundred annotated references dealing with institutional regulations and standards of care, disability determinations, decisionmaking for critically ill patients, involuntary commitment, advocacy services for the older health care consumer, and many other topics. Citations consist of books, book chapters, journal articles, and reports published from 1980 onwards. Entries are cross-referenced systematically, and author and subject indexes are provided. This important new reference will be an invaluable working tool for professionals and students who need to understand and deal with some of the most difficult issues in the field of modern health care.

Today, most people use prescription medications. Every year, the multi-billion dollar pharmaceutical industry produces new medicines that treat everything from arthritis to AIDS, from high cholesterol to depression. But, despite recent controversies regarding the safety of drugs, consumers know little about the medications that they ingest and inject. How are these new medicines invented? How do consumers know that drugs are safe and effective? How are they tested? Who regulates their production - and who watches the regulators? How do drug companies produce the vast quantities needed for the marketplace, and why do they market their drugs as they do? The New Medicines leads the reader through the maze of the modern drug industry - from bench to bedside - and provides consumers with a step-by-step understanding of how new medicines are created, approved, marketed, and sold. In addition to explaining how drugs reach the medicine cabinet, the author - an experienced researcher and teacher - provides the scientific and business background for understanding the current controversial issues surrounding new medicines, such as:

• The rise and fall of the COX-2 inhibitors, Vioxx and Celebrex, and the process by which they were invented, approved, and re-evaluated.
• The saga of the cancer drug Erbitux and its creator, the company Imclone, made famous as the centerpiece of the Martha Stewart insider-trading scandal
• The strengths and weaknesses of the approval process of the Food and Drug Administration
• The controversial new marketing techniques of the pharmaceutical industry

"Brackenridge's Medical Selection of Life Risks" has long been recognized as the leading reference book on insurance medicine. The fifth edition provides a comprehensive guide to life expectancy for underwriters and clinicians involved in the life insurance industry. Extensively revised and expanded the new edition reflects developments in life and healthcare insurance as well as medicine. There is expanded coverage of disability issues and full account is taken of new developments in genetics and gene therapy and also recent technology and regulatory and compliance issues. Part I deals with the principles of life and disability insurance and the logistics of life underwriting. Part II is devoted to a systematic clinical appraisal of underwriting problems, mainly relating to life insurance but also, where appropriate, to disability, critical illness and long term care insurance.

All healthcare professionals working with complementary therapies must be fully aware of legal boundaries, responsibilities and liabilities in the practice of complementary therapies. This book covers all the main topics and principles and deals with points specific to individual therapies, helping practitioners to practice confidently.Legal aspects of using and integrating complementary therapies in health care practice present an area of anxiety for therapists, nurses and others Bridget Dimond is very well known in the UK as a speaker in this topic. It is the subject on which she is most frequently asked to talk at conferences.Information is clearly presented and extremely practical

The authors of this work closely explore the incidence of problem youth behaviors and scrutinize the efficacy of existing prevention programs. This review includes interventions specifically designed to promote youth development or to minimize the long-term consequences of problem behaviors from violence and criminality, substance use and abuse, teen pregnancy and hazardous sexual behaviors, and school failure. Academics and professionals in public health social work, psychology, and school counseling will find special interest in this important work.

Can medical ethics be legislated? Can a complex bioethical question be definitively answered through legislation? In July 1987 the New York State legislature experimented with legislating medical ethics by amending the state's public health law to regulate Do Not Resuscitate' orders. The consequent law was complex and remains controversial. This volume reviews both the background bioethical debates and the elements of the public policy making process that are essential to understanding New York's experience with the DNR law. It features debates between leading exponents and critics of the law; case studies that examine the impact of New York's DNR law on clinicians, hospitals and patients; and a review of all empirical studies of the law by their lead authors. Appended to the volume is the New York State DNR law and a comprehensive set of background documents. The co-editors, Robert Baker and Martin A. Strosberg, are both professors at Union College, Schenectady, New York. They have collaborated on many projects including, Rationing America's Medical Care: The Oregon Plan and Beyond (Brookings, 1992).

Legal Medicine explores the legal issues that arise from government policy influencing medical practice, advances in medical technology, and new disease patterns. Articles by renowned experts cover timely and practical issues as well as academic and philosophical themes. This new volume contains incisive analyses of such topics as the medical and legal considerations in the treatment of AIDS patients, the use of lasers, the Bhopal tragedy, and the use of implantable cardiovascular devices.

Once dialysis treatment, in 1960, permitted life prolongation for some but not all patients in kidney failure, an ethical genie' was released. The introduction of peritoneal dialysis and kidney transplantation compounded the physician's dilemma by underscoring those left untreated. Who should be selected for uremia therapy? Should exclusion from treatment be properly delegated to administrators or physicians, or better left to a committee? Are some candidates more worthy than others? As examples: Do Presidents and Kings warrant priority in cadaver organ allocation over ordinary citizens? Are rich people more deserving than the poor? Is it ethical to choose a younger over an older patient? Can children and/or mentally incompetent persons serve as living organ donors? Is it proper to market organs under controlled circumstances? Eli A. Friedman, an experienced nephrology training program director, and Medical Advisor to the American Association of Kidney Patients, has collected 24 difficult cases that focus on these and other vexing though common stressful issues faced by those who manage kidney patients. Using a novel approach to each case, the opinions of lawyers, nephrologists, patients, and a transplant surgeon are proffered sequentially. Friedman asks and then answers searching questions arising from the debate. The quality of information presented is positively flavored by the fact that three of the respondents (one an attorney) are kidney transplant recipients. Members of the kidney team, those immersed in seeking truth in medical ethics, and all participating in exploring the legality or ethical basis of organ replacement will find this book pertinent to their effort.

Language, Literacy, and Health: Discourse in Brazils National Health System analyzes language, literacy, and health as social practices, with a focus on Brazils national health system, the Unified Health System (SUS). The SUS was established in the 1990s, offering free consultations, health promotion activities, and home visits by a professional team to the Brazilian population, and of particular interest is the Family Health Strategy program. This book is based on research conducted in two different Brazilian regions, the Northeast and the Southeast. Izabel Magalhaes and Kenia Lara da Silva discuss language and literacy as discourse-a very important dimension of health practice-and different uses of texts, including multimodal texts. The research and analysis, and the authors' ethnographic approach, bring to light some issues with SUS practices, and the authors suggest improvements. The book contributes to the debate about language and literacy in health practices, in which patients are partly responsible for keeping well.

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles.

The Sunday Times top ten bestseller... 'Nobody knew what was going on behind those doors. We were human toys. Just a piece of meat for someone to play with.' Barbara O'Hare was just 12 when she was admitted to the psychiatric hospital, Aston Hall, in 1971. From a troubled home, she'd hoped she would find sanctuary there. But within hours, Barbara was tied down, drugged with sodium amytal - a truth-telling drug - and then abused by its head physician, Dr Kenneth Milner. The terrifying drug experimentation and relentless abuse that lasted throughout her stay damaged her for life. But somehow, Barbara clung on to her inner strength and eventually found herself leading a campaign to demand answers for potentially hundreds of victims. A shocking account of how vulnerable children were preyed upon by the doctor entrusted with their care, and why it must never happen again.

The use of human beings as research subjects poses distinctive ethical issues. Subjects of medical research are exposed to risks of harm for the sake of generating scientific knowledge that can benefit future patients and society. Ethical analysis of the challenges posed by research involving human subjects requires careful attention to the contextual details of scientific experimentation. This book contains 22 essays by Franklin G. Miller on research ethics written over a 15-year period. With the exception of the first essay, all have been previously published in bioethics and medical journals. The book is arranged into four parts. Part One addresses a general ethical perspective on the protection of human subjects in clinical research, including paternalism in research regulation and acceptable limits to research risks. The essays in Part Two examine ethical issues in study design. It includes ethical analyses of controversial types of medical experimentation-studies that provoke psychiatric symptoms, induce infections, provide patients with placebos that withhold proven effective treatments or administer fake invasive procedures, test experimental treatments in cancer patients who have exhausted all standard treatment options, and employ the use of deception to generate scientifically valid data. Part Three offers a systematic critique of "the therapeutic orientation" to clinical trials and the principle of clinical equipoise, which is widely regarded as a fundamental norm for randomized treatment studies. Part Four takes up a range of ethical issues relating to informed consent for research participation, including examination of "the therapeutic misconception" and presentation of a novel approach to the validity of consent: "the fair transaction model." An abiding theme, developed in many of the essays is that the ethics of clinical research is importantly different from the ethics of medical care.

Dealing with major issues in Jewish biomedical law, this book focuses upon the influence of morality, the rise of patient autonomy, and the role played by scientific progress in this area of Jewish Law. The book examines Jewish Law in comparison with canon, common, and modern Israeli law.

Transfusion medicine is an excellent way for the healthy community to help the sick. However, service providers and patients have much to gain from the establishment of guidelines concerning when and how it is used. An important first step would be to introduce informed consent for transfusion recipients. Discussions with blood banks and assessment of clinical demand would also be necessary, taking into account the needs of patients and physicians, and the availability of products. Unfortunately, the efficacy and safety of transfusion products can be difficult to ascertain. Furthermore, although major advances have been made in safety, the risks of giving and receiving blood are still seen as high. It is vital to learn what underlies that perception and how to counter it. The policies and protocols used to establish surgical criteria for blood transfusions should be explored. Finally, clinical audits can help evaluate the risk: benefit ratio of transfusion; they may be carried out by hospital transfusion committees but are likely to be more successful with the support of national and international legislative and regulatory bodies. The implementation of appropriate initiatives now will improve the outlook for the future of transfusion medicine, perhaps with ex-vivo expanded haemopoietic cell therapy as the next milestone. All these key points and controversies are explored in this book, which paints a broad picture of the current status and future trends in transfusion medicine.

The motivation and inspiration for this book come directly from expe- ences with clients during the years that I practiced HIV-related law at the Legal Aid Society of San Diego, Inc. The issues discussed in this work reflect issues that arose on a recurring basis with clients participating in HIV research studies, with investigators calling for guidance on the legal implications of particular aspects of their proposed studies, and with research institutions and health care facilities struggling to make sense of legal maneuvers aimed at obtaining the records of their HIV-infected patients. It is impossible to thank each of these persons individually for their provocative questions and their insights. The discussion of ethical and legal issues relating to the design of clinical trials reflects questions raised during discussions with Donald J. Slymen, Ph.D. Don was one of the first researchers, in my realm of experience, to pay close attention to ethical concerns, and I am greatly appreciative of his contribution to both my professional growth and the development of various scenarios discussed in this text. The portions of this text dealing with confidentiality are the result of many hours of thoughtful discussion and analysis with Penn Lerblance, J.D., now deceased and still missed. Penn and I often participated together as presenters of in-service training programs for health prof- sionals. Penn addressed discrimination, and I focused on confidentiality.

Dementia is a topic of enormous human, medical, economic, legal and ethical importance. Its importance grows as more of us live longer. The legal and ethical problems it raises are complex, intertwined and under-discussed. This book brings together contributions from clinicians, lawyers and ethicists - all of them world leaders in the field of dementia - and is a comprehensive, scholarly yet accessible library of all the main (and many of the fringe) perspectives. It begins with the medical facts: what is dementia? Who gets it? What are the current and future therapeutic and palliative options? What are the main challenges for medical and nursing care? The story is then taken up by the ethicists, who grapple with questions such as: is it legitimate to lie to dementia patients if that is a kind thing to do? Who is the person whose memory, preferences and personality have all been transformed by their disease? Should any constraints be placed on the sexual activity of patients? Are GPS tracking devices an unpardonable interference with the patient's freedom? These issues, and many more, are then examined through legal lenses. The book closes with accounts from dementia sufferers and their carers. It is the first and only book of its kind, and the authoritative text.

Continually changing health threats, technologies, science, and demographics require that public health professionals have an understanding of law sufficient to address complex new public health challenges as they come into being. Law in Public Health Practice, Second Edition provides a thorough review of the legal basis and authorities for the core elements of public health practice and solid discussions of existing and emerging high-priority areas where law and public health intersect.
As in the previous edition, each chapter is authored jointly by experts in law and public health. This new edition features three completely new chapters, with several others thoroughly revised and updated. New chapters address such topics as the structure of law in US public health systems and practice, the role of the judiciary in public health, and law in chronic disease prevention and control. The chapter on public health emergencies has also been fully revised to take into account both the SARS epidemic of 2003 and the events of the Fall of 2001. The chapter now discusses topics such as the legal basis for declaring emergencies, the legal structure of mutual aid agreements, and the role of the military in emergencies. Other fully revised chapters include those on genomics, injury prevention, identifiable health information, and ethics in the practice of public health.
The book begins with a section on the legal basis for public health practice, including foundations and structure of the law, discussions of the judiciary, ethics and practice of public health, and criminal law and international considerations. The second section focuses on core public health applications and the law, andincludes chapters on legal counsel for public health practitioners, legal authorities for interventions in public health emergencies, and considerations for special populations. The third section discusses the law in controlling and preventing diseases, injuries, and disabilities. This section includes chapters on genomics, vaccinations, foodborne illness, STDs, reproductive health, chronic disease control, tobacco use, and occupational and environmental health.
All chapters take a practical approach and are written in an accessible, user-friendly fashion. This is an excellent resource for a wide readership of public health practitioners, lawyers, and healthcare providers, as well as for educators and students of law and public health.

While health professionals may be adequately informed about the legal aspects of many specialized areas of medicine and nursing, they may not totally understand the law applicable to cases of dying patients, or even the legal definition of death itself. In the wake of advances in medical technology, recent court decisions on the right to die, the enactment of natural death and brain death statutes, advance directives and living wills, and growing use of organ transplantation, there has been widespread concern about the legal and ethical issues surrounding these subjects. This book, written by a lawyer-thanatologist, will satisfy these needs. It is the first work to bring together case and statutory law applicable to dying patients, the right to die, advance directives, brain death, and organ transplantation, thus formulating a law of dying and death.

It is also unique as a self-help law finder. Although occasions that require consultation with a lawyer will arise, this work gives health professionals practical guidance on where and how to find legal materials on these issues. This book should also prove immensely useful in summarizing the law concerning dying and death for professional legal counsel. Medical decisions and issues that once were the sole province of doctors, hospitals, patients, and families have become matters of increasing judicial and legislative attention.

Analyzing the level of claims for clinical negligence in the light of the most recent trends and discovering whether there is indeed a litigation crisis in healthcare, this book is a topical and compelling exploration of healthcare and doctor-patient relationships.

The author:

• identifies and analyzes the growing pressures on doctors in modern society, placing their role in context
• explores some of the myths surrounding media claims about malpractice
• considers the practice of 'defensive medicine' and the difference between defensive practices and sensible risk management
• examines external pressures, such as political interference with clinical practice in the form of target-setting and what might be described as a culture of creeping privatization of healthcare.

Covering the topics of medicine and the media and the causes of occupational stress among doctors, this volume is a must read for all students of medical law and medical ethics.

Your primary source for information on the legal issues of pharmaceutical practice, care, and activity Today's pharmacist is faced with legal, ethical, and moral concerns in making the transition from traditional pharmacy practice to an expanded role in clinical pharmacy and patient drug management services. Pharmacy Law Desk Reference is a primer on the legal aspects of pharmaceutical practice, providing background on foundational legal concepts, and guidance on the Food, Drug, and Cosmetic Act (FDCA), the Controlled Substances Act (CSA), and the Federal Trade Commission. This unique book examines the major topics that impact pharmaceutical care, including professional liability insurance; the need for supportive personnel in pharmacy practice; patent law, trademarks, and copyrights; law and ethics; business law; HIPAA privacy in the pharmacy; electronic prescribing; and medication error reporting. Handy tables, figures, and exhibits make complex information easy to access and understand. The better pharmacists understand the regulatory and legislative framework that shapes their practice, the better they will be able to carry out their responsibilities to patients. Pharmacy Law Desk Reference offers a broad scope on established legal subjects, the current direction of the profession, and important contemporary topics that affect the clinical role of the practicing pharmacist. Each chapter is authored by a nationally recognized authority on one or more aspect of pharmacy law and many of the contributors are active in the American Society of Pharmacy Law. Topics addressed in Pharmacy Law Desk Reference include: telepharmacy collaborative drug therapy management trade secrets and trade secret protection anti-competitive practices the threat of civil and criminal liability the Health Insurance Portability and Accountability Act of 1996 (HIPAA) FDA inspections consumer protection laws credentialing pharmacy compounding accreditation employment contracts Medicaid and Medicare controlled substance registration and prescription orders forged prescription orders and many more Pharmacy Law Desk Reference is a comprehensive resource on the professional, legal, and contemporary issues in pharmacy practice. It is a primary reference guidebook for pharmacy practitioners, leaders of state and national pharmacists associations, members of state boards of pharmacy, educators and students, and an essential addition to all pharmacy libraries.

Your primary source for information on the legal issues of pharmaceutical practice, care, and activity Today's pharmacist is faced with legal, ethical, and moral concerns in making the transition from traditional pharmacy practice to an expanded role in clinical pharmacy and patient drug management services. Pharmacy Law Desk Reference is a primer on the legal aspects of pharmaceutical practice, providing background on foundational legal concepts, and guidance on the Food, Drug, and Cosmetic Act (FDCA), the Controlled Substances Act (CSA), and the Federal Trade Commission. This unique book examines the major topics that impact pharmaceutical care, including professional liability insurance; the need for supportive personnel in pharmacy practice; patent law, trademarks, and copyrights; law and ethics; business law; HIPAA privacy in the pharmacy; electronic prescribing; and medication error reporting. Handy tables, figures, and exhibits make complex information easy to access and understand. The better pharmacists understand the regulatory and legislative framework that shapes their practice, the better they will be able to carry out their responsibilities to patients. Pharmacy Law Desk Reference offers a broad scope on established legal subjects, the current direction of the profession, and important contemporary topics that affect the clinical role of the practicing pharmacist. Each chapter is authored by a nationally recognized authority on one or more aspect of pharmacy law and many of the contributors are active in the American Society of Pharmacy Law. Topics addressed in Pharmacy Law Desk Reference include: telepharmacy collaborative drug therapy management trade secrets and trade secret protection anti-competitive practices the threat of civil and criminal liability the Health Insurance Portability and Accountability Act of 1996 (HIPAA) FDA inspections consumer protection laws credentialing pharmacy compounding accreditation employment contracts Medicaid and Medicare controlled substance registration and prescription orders forged prescription orders and many more Pharmacy Law Desk Reference is a comprehensive resource on the professional, legal, and contemporary issues in pharmacy practice. It is a primary reference guidebook for pharmacy practitioners, leaders of state and national pharmacists associations, members of state boards of pharmacy, educators and students, and an essential addition to all pharmacy libraries.

To what extent should parents be able to choose the kind of child they have? The unfortunate phrase 'designer baby' has become familiar in debates surrounding reproduction. As a reference to current possibilities the term is misleading, but the phrase may indicate a societal concern of some kind about control and choice in the course of reproduction. Typically, people can choose whether to have a child. They may also have an interest in choosing, to some extent, the conditions under which they do so, such as whether they have a child with a serious disability or disease. The purpose of this book is to explore the difficult and controversial question of the appropriate ethical and legal extent of reproductive autonomy in this context. The book examines ethical, legal and public policy issues in prenatal screening, prenatal diagnosis (PND), selective abortion and preimplantation genetic diagnosis (PGD). It explores the ethics of these selection practices and the ability of current ethical guidelines and legal mechanisms, including the law on selective abortion and wrongful birth, to deal with advances in genetic and other knowledge in these areas. Unlike in the United States, in England the relevant law is not inherently rights-based, but the impact of the Human Rights Act 1998 inevitably raises questions about the proper scope of reproductive autonomy in this context. The implications of the analysis are considered for the development of relevant law, public policy and ethical guidelines and will be of interest to academics in medical law and ethics, health professionals, lawyers, those working on public policy and students with an interest in these issues.

What are the moral challenges that confront doctors as they manage healthcare institutions? How do we build trust in medical organisations? How do we conceptualize moral action? Based on accounts given by senior doctors from organisations throughout the UK, this book discusses the issues medical leaders find most troubling and identifies the moral tensions they face. Moral Leadership in Medicine examines in detail how doctors protect patients' interests, implement morally controversial change, manage colleagues in difficulty and rebuild trust after serious medical harm. The book discusses how leaders develop moral narratives to make sense of these situations, how they behave while balancing conflicting moral goals and how they influence those around them to do the right thing in difficult circumstances. Based on empirical ethical analysis, this volume is essential reading for clinicians in leadership roles and students and academics in the fields of healthcare management, medical law and healthcare ethics.