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.

The perfect textbook for healthcare students who want a fresh, innovative way to understand how law and ethics relate to their studies, placements, and professional practice. By using a unique format made up of frequently asked questions and corresponding answers, Key Questions in Healthcare covers the what, why, where and how in legal and ethical issues related to healthcare. Its easy-to-use layout helps you quickly find informative yet straightforward answers to over 150 questions, helping you to feel confident in your legal and ethical knowledge, without leaving you overwhelmed or confused. All answers are written in-line with Nursing and Healthcare regulations and its conversational writing style will make you feel like you are talking with a lecturer, instructor, or knowledgeable colleague, rather than reading a textbook. The book is appropriate for all levels, from healthcare students in the initial stages of their education, to the advanced practitioner who wishes to refresh their knowledge, or maybe learn something new.

Health Care and the Charter explores the systematic use of Charter litigation in the area of health care and the policy impact of the resulting judicial decisions. Christopher P. Manfredi and Antonia Maioni examine three of the most controversial Supreme Court decisions in recent years. Eldridge (1997) and Auton (2004) invited the Court to extend the scope of publicly funded services, while Chaouilli (2005) asked the Court to allow private health services. This book explores the paths that brought litigants to the Court, the arguments that supported their positions, and the substance of the victory or defeat the Court provided.

How ought the law to deal with novel challenges regarding the use and control of human biomaterials? As it stands the law is ill-equipped to deal with these. Quigley argues that advancing biotechnology means that the law must confront and move boundaries which it has constructed; in particular, those which delineate property from non-property in relation to biomaterials. Drawing together often disparate strands of property discourse, she offers a philosophical and legal re-analysis of the law in relation to property in the body and biomaterials. She advances a new defence, underpinned by self-ownership, of the position that persons ought to be seen as the prima facie holders of property rights in their separated biomaterials. This book will appeal to those interested in medical and property law, philosophy, bioethics, and health policy amongst others.

Systematically improving patient safety is of the utmost importance, but it is also an extremely complex and challenging task. This illuminating study evaluates the role of professionalism, regulation and law in seeking to improve safety, arguing that the 'medical dominance' model is ill-suited to this aim, which instead requires a patient-centred vision of professionalism. It brings together literatures on professions, regulation and trust, while examining the different legal mechanisms for responding to patient safety events. Oliver Quick includes an examination in areas of law which have received little attention in this context, such as health and safety law, and coronial law, and contends in particular that the active involvement of patients in their own treatment is fundamental to ensuring their safety.

When Henry Morgentaler, Canada’s best-known abortion rights advocate, died in 2013, activists and scholars began to reassess the state of abortion in the country. In this volume, some of Canada’s foremost researchers challenge current thinking about abortion by revealing the discrepancy between what Canadians believe the law to be after the 1988 Morgentaler decision and what people are experiencing on the ground. Showcasing new theoretical frameworks and approaches from law, history, medicine, women’s studies, and political science, these timely essays reveal the diversity of abortion experiences across the country, past and present, and make a case for shifting the debate from abortion rights to reproductive justice.

For decades, manufacturers from around the world relied on asbestos from the town of Asbestos, Quebec, to produce fire-retardant products. Then, over time, people learned about the mineral's devastating effects on human health. Dependent on this deadly industry for their community's survival, the residents of Asbestos developed a unique, place-based understanding of their local environment; the risks they faced living next to the giant opencast mine; and their place within the global resource trade. This book unearths the local-global tensions that defined Asbestos's proud and painful history to reveal the challenges similar resource communities have faced - and continue to face today.

This book provides a multi-disciplinary framework for developing and analysing health sector reforms, based on the authors' extensive international experience. It offers practical guidance, and stresses the need to take account of each country's economic, administrative, and political circumstances. The authors explain how to design effective government interventions in five areas - financing, payment, organization, regulation, and behaviour - to improve the performance and equity of health systems around the world.

Effective palliative care that rests on a sound ethical foundation requires ongoing discussions about patient and family values and preferences. This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death. The eighth volume in the HPNA Palliative Nursing Manuals series, Legal and Ethical Aspects of Palliative Care, provides an overview of critical communication skills and formal organizational mechanisms, such as ethics committees and interdisciplinary rounds, required for decisions in ethical dilemmas which respect diversity in the views of colleagues, as well as patients. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice.

Malaria is an infectious disease like no other: it is a dynamic force of nature and Africa’s most deadly and debilitating malady. James C. McCann tells the story of malaria in human, narrative terms and explains the history and ecology of the disease through the science of landscape change. All malaria is local. Instead of examining the disease at global or continental scale, McCann investigates malaria’s adaptation and persistence in a single region, Ethiopia, over time and at several contrasting sites. Malaria has evolved along with humankind and has adapted to even modern-day technological efforts to eradicate it or to control its movement. Insecticides, such as DDT, drug prophylaxis, development of experimental vaccines, and even molecular-level genetic manipulation have proven to be only temporary fixes. The failure of each stand-alone solution suggests the necessity of a comprehensive ecological understanding of malaria, its transmission, and its persistence, one that accepts its complexity and its local dynamism as fundamental features. The story of this disease in Ethiopia includes heroes, heroines, witches, spirits—and a very clever insect—as well as the efforts of scientists in entomology, agroecology, parasitology, and epidemiology. Ethiopia is an ideal case for studying the historical human culture of illness, the dynamism of nature’s disease ecology, and its complexity within malaria.

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.

This book approaches a variety of social and political issues that have become highly polarized and resistant to compromise by examining them through a population-based public health perspective. The topics included are some of the most contentious: abortion and reproductive rights; end-of-life issues, including the right to die and the treatment of pain; the connection between racism and poor health outcomes for African-Americans; the right of same-sex couples to marry; the toll of gun violence and how to reduce it; domestic violence and how the criminal justice model fails to deal with it effectively; and how tort compensation and punitive damages can further public health goals. People at every point along the political spectrum will find the book enlightening and informative. Written by eight authors, all of whom have cross-disciplinary expertise, this book shifts the focus away from the point of view of rights, politics, or morality and examines the effect of laws and policies from the perspective of public health and welfare.

The Medical Biobank of Umea in Sweden, deCODE's Health Sector Database in Iceland, the Estonian Genome Project and the UK Biobank contain health data and genetic data from large populations. Some include genealogical or lifestyle information. They are resources for research in human genetics and medicine, exploring interaction between genes, lifestyle, environmental factors and health and diseases. The collection, storage and use of this data raise ethical, legal and social issues. In this book, first published in 2007, bioethics scholars examine whether existing ethical frameworks and social policies reflect people's concerns, and how they may need to change in light of new scientific and technological developments. The ethical issues of social justice, genetic discrimination, informational privacy, trust in science and consent to participation in database research are analyzed, whilst an empirical survey, conducted in the four countries, demonstrates public views of privacy and related moral values in the context of human genetic databases.

Among the ablest anatomical teachers of his day, Robert Knox (1791-1862) also busied himself with the study of zoology and ethnology. Prepared by his pupil and colleague Henry Lonsdale (1816-76), this 1870 biography explores the scope of Knox's scientific research and the nature of his character. It describes how Knox developed at Edinburgh one of the most significant anatomical schools in Britain, playing a dominant role in expanding the comparative anatomy collection held by the city's Royal College of Surgeons. Despite his eminence and popularity as a lecturer, his reputation was deeply tarnished by his association with the notorious murderers Hare and Burke, who had provided Knox with bodies for dissection. Drawing on surviving correspondence and information gathered from friends and colleagues, Lonsdale's work stands as a robust defence and sympathetic portrait of a prominent yet controversial figure in the history of nineteenth-century medicine.

In America, in direct response to indefinite delays on the national transplantation waitlists and an inadequate supply of organs, a growing number of terminally ill Americans are turning to international underground markets and coordinators or brokers for organs. Chinese inmates on death-row and the economically disadvantaged in India and Brazil are the often compromised co-participants in the private negotiation process, which occurs outside the legal process - or in the shadows of law. These individuals supply kidneys and other organs for Americans and other Westerners willing to shop and pay in the private process. This book contends that exclusive reliance on the present altruistic tissue and organ procurement processes in the United States is not only rife with problems, but also improvident. The author explores how the altruistic approach leads to a 'black market' of organs being harvested from Third World individuals as well as compelled donations from children and incompetent persons.

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.

Daniel Callahan---whose cofounding of The Hastings Center in 1969 was one of the most important milestones in the history of bioethics--has written on an uncommonly wide range of issues over a long career. They have moved back and forth between clinical care of individual patients and the ethical problems of health care research and delivery. Through his many writings, four core problems have recurred in all of his work, and influence each of the others. What is health and how has its understanding been shaped by medical progress and the culture of medicine and society? What is progress, a deep value in modern health care and how should we judge it? What kinds of technological innovations that come out of the drive for progress are really good for us-and what do we do when there is a clash between individual good and social good in the use of expensive technologies, a problem now evident in the unsustainable high costs of health care? How should our understanding of the place of an inevitable death in all our lives, and its place in medicine, help us to better think of the goals of medicine and the goals of our life in seeking a good death? Those four questions have been with bioethics from its beginning and will remain with it for the indefinite future. They are the roots of bioethics.

Two towering figures in the field of health care policy analysis, Theodore R. Marmor and Rudolf Klein, reflect on a lifetime of thought in this wide-ranging collection of essays published in the wake of President Obama's health care reform. Presented as a kind of dialogue between the two, the book offers their recent writings on the future of Medicare; universal health insurance; conflicts of interest among physicians, regulators, and patients; and many other topics.

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.

This volume in "The SAGE Reference Series on Disability "explores ethical, legal, and policy issues of people with disabilities, and is one of eight volumes in the cross-disciplinary and issues-based series, which examines topics central to the lives of individuals with disabilities and their families. With a balance of history, theory, research, and application, specialists set out the findings and implications of research and practice for others whose current or future work involves the care and/or study of those with disabilities, as well as for the disabled themselves. The presentational style (concise and engaging) emphasizes accessibility. Taken individually, each volume sets out the fundamentals of the topic it addresses, accompanied by compiled data and statistics, recommended further readings, a guide to organizations and associations, and other annotated resources, thus providing the ideal introductory platform and gateway for further study. Taken together, the series represents both a survey of major disability issues and a guide to new directions and trends and contemporary resources in the field as a whole.

Back pain and back injury is an extremely common problem, producing chronic, debilitating symptoms for sufferers, and resulting in millions of pounds of lost revenue in absence from work and paid in compensation for spinal injuries. The Medico-Legal Back is the first book to address all aspects of the problem for a legal readership, in a clear, concise and reader-friendly style. It does away with the need to search for and then extract complex information from many different sources, and as such will be an indispensable guide to the problem for all lawyers, judges and medico-legal experts, as well as being of value to the orthopaedic surgeon with an interest in the spine. Of particular value is the use throughout the book of analogies drawn on anatomical technicalities and common movements, situations and incidents of everyday life. Fully illustrated throughout, with real scans using imaging modalities, and line diagrams generated especially for this title, The Medico-Legal Back should be on the shelves of all medico-legal personnel at all levels of expertise and experience.

In recent years the need for specialist knowledge of the laws governing the regulation of medicines has become apparent. This is the case among not only lawyers but also hospitals, researchers, prescribers and many others involved in the provision of healthcare. Such a need has been precipitated by a number of factors including the changing structure of healthcare in the UK and Europe, the increasing specialisation in litigation relating to medicines' control and provision and the various changes in regulation that have arisen both from challenges in the courts and from the intervention of public bodies. Until now the information resources available to those involved in the complex interrelations between medicines, medical devices and the law have remained scarce. This book is designed to address this situation by bringing together the knowledge of the laws governing the regulation of medicines of the most experienced and qualified experts in one volume ranging across all aspects of the field. All areas of the law relating to the research, development, manufacture, distribution and dispensation of medicines and medical devices in the UK are covered as well as various topics within the law governing responsibilities, procedures and compensation in cases of malpractice and injury.

People with somatoform disorder (which used to be known as hysteria) present with a range of symptoms that typically last for years and can't be traced to a specific physical cause. Such symptoms may include frequent headaches; back pain; abdominal cramping and pelvic pain; pain in the joints, legs and arms; chest or abdominal pain, and gastrointestinal problems. This book is an in-depth, clinically orientated review of the somatoform disorders and related clinical presentations (such as chronic fatigue syndrome) and how they present in a medico-legal setting. It is aimed at both clinicians and lawyers who deal with injury claims where these disorders impact much more frequently than is generally recognised.