Internationally renowned medical scientist, frequent media contributor, and autism dad Dr. Peter J. Hotez explains why vaccines do not cause autism. In 1994, Peter J. Hotez's nineteen-month-old daughter, Rachel, was diagnosed with autism. Dr. Hotez, a pediatrician-scientist who develops vaccines for neglected tropical diseases affecting the world's poorest people, became troubled by the decades-long rise of the influential anti-vaccine community and its inescapable narrative around childhood vaccines and autism. In Vaccines Did Not Cause Rachel's Autism, Hotez draws on his experiences as a pediatrician, vaccine scientist, and father of an autistic child. Outlining the arguments on both sides of the debate, he examines the science that refutes the concerns of the anti-vaccine movement, debunks current conspiracy theories alleging a cover-up by the Centers for Disease Control and Prevention, and critiques the scientific community's failure to effectively communicate the facts about vaccines and autism to the general public, all while sharing his very personal story of raising a now-adult daughter with autism. A uniquely authoritative account, this important book persuasively provides evidence for the genetic basis of autism and illustrates how the neurodevelopmental pathways of autism are under way before birth. Dr. Hotez reminds readers of the many victories of vaccines over disease while warning about the growing dangers of the anti-vaccine movement, especially in the United States and Europe. Now, with the anti-vaccine movement reenergized in our COVID-19 era, this book is especially timely. Vaccines Did Not Cause Rachel's Autism is a must-read for parent groups, child advocates, teachers, health-care providers, government policymakers, health and science policy experts, and anyone caring for a family member or friend with autism. "When Peter Hotez-an erudite, highly trained scientist who is a true hero for his work in saving the world's poor and downtrodden-shares his knowledge and clinical insights along with his parental experience, when his beliefs in the value of what he does are put to the test of a life guiding his own child's challenges, then you must pay attention. You should. This book brings to an end the link between autism and vaccination."-from the foreword by Arthur L. Caplan, NYU School of Medicine

In the 1850s, "Drapetomania" was the medical term for a disease found among black slaves in the United States. The main symptom was a strange desire to run away from their masters. In earlier centuries gout was understood as a metabolic disease of the affluent, so much so that it became a badge of uppercrust honor -- and a medical excuse to avoid hard work. Today, is there such a thing as mental illness, or is mental illness just a myth? Is Alzheimer's really a disease? What is menopause -- a biological or a social construction?Historically one can see that health, disease, and illness are concepts that have been ever fluid. Modern science, sociology, philosophy, even society -- among other factors -- constantly have these issues under microscopes, learning more, defining and redefining ever more exactly. Yet often that scrutiny, instead of leading toward hard answers, only leads to more questions. Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine. Divided into four parts -- Historical Discussions; Characterizing Health, Disease, and Illness; Clinical Applications of Health and Disease; and Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease -- the reader can see the evolutionary arc of medical concepts from the Greek physician Galen of Pergamum (ca. 150 ce) who proposed that "the best doctor is also a philosopher," to contemporary discussions of the genome and morality. The editors have recognized a crucial need for a deeper integration of medicine and philosophy with each other, particularly in an age of dynamicallychanging medical science -- and what it means, medically, philosophically, to be human.

Genetic counseling is fairly new. The fact that the field is an accepted professional enterprise in universities, clinics, and hospitals throughout the United States is remarkable. The contributors argue that genetics and medicine rest on beliefs widely held in American society. Scientific progress is good, and highly sophisticated technologies are appropriate means to solving medical problems. The better understanding they gain about the nature and evolution of disease, the more prepared clinicians will be to treat and prevent future occurrence of disease. A belief that medicine, including genetic medicine, is clear, factually based, and objective undergirds the strategies and norms of genetic counseling. This collection of original papers explores the history, values, and norms of that process, with focus on the value of non-directiveness in counseling practice. The contributors' examination of genetic counseling issues serves as a foundation from which to address the ethical, legal, and policy considerations of clinical genetics.

Dianne M. Bartels is associate director of the Center for Bioethics and assistant professor of medicine and bioethics at the University of Minnesota. She is the author or co-author of numerous books, including Beyond Baby M, Facilitating the Genetic Counseling Process, and Genetic Counseling Practice.

Bonnie S. LeRoy is director of the graduate program in genetic counseling and professor of genetics, cell biology, and development at the University of Minnesota. Her major area of research interest involves ethical and social challenges associated with genetic counseling.

Arthur L. Caplan is Emanuel and Robert Hart Professor of Bioethics at the University of Pennsylvania. His work has appeared in numerous publications, including Th e American Journal of Bioethics, Addiction, and Lancet.

Genetic counseling is fairly new. The fact that the field is an accepted professional enterprise in universities, clinics, and hospitals throughout the United States is remarkable. The contributors argue that genetics and medicine rest on beliefs widely held in American society. Scientific progress is good, and highly sophisticated technologies are appropriate means to solving medical problems. The better understanding they gain about the nature and evolution of disease, the more prepared clinicians will be to treat and prevent future occurrence of disease. A belief that medicine, including genetic medicine, is clear, factually based, and objective undergirds the strategies and norms of genetic counseling. This collection of original papers explores the history, values, and norms of that process, with focus on the value of non-directiveness in counseling practice. The contributors' examination of genetic counseling issues serves as a foundation from which to address the ethical, legal, and policy considerations of clinical genetics.

In Replacement Parts, internationally recognized bioethicist Arthur L. Caplan and coeditors James J. McCartney and Daniel P. Reid assemble seminal writings from medicine, philosophy, economics, and religion that address the ethical challenges raised by organ transplantation. Caplan's new lead essay explains the shortfalls of present policies. From there, book sections take an interdisciplinary approach to fundamental issues like the determination of death and the dead donor rule; the divisive case of using anencephalic infants as organ donors; the sale of cadaveric or live organs; possible strategies for increasing the number of available organs, including market solutions and the idea of presumed consent; and questions surrounding transplant tourism and "gaming the system" by using the media to gain access to organs. Timely and balanced, Replacement Parts is a first-of-its-kind collection aimed at surgeons, physicians, nurses, and other professionals involved in this essential lifesaving activity that is often fraught with ethical controversy.

No one argues the need for transplants. The debate centers on how to satisfy the great need for healthy organs. Advances in medical technology and science have made organ procurement, or the search and transfer of organs and tissue from one body to another, a very important issue. Since the demand for healthy organs far exceeds the supply, many questions enter this debate, blending medicine with politics, ethics, research, religion, and other concerns. How are we to meet the need? Can we do so and still respect personal ethics and religious convictions? Can organs be obtained without turning medical emergencies into free-market enterprise? Should people be permitted to sell their organs? Should animals be sacrificed to save the lives of humans? Could cloning be considered as a future source of organs?
With more than thirty of the most important, influential, and up-to-date articles from leaders in ethics, medicine, philosophy, law, and politics, The Ethics of Organ Transplants examines the numerous and tangled issues that surround organ procurement and distribution.
Co-edited by Dr. Arthur L. Caplan, a world recognized scholar in bioethics and health policy, this volume divides the issue into five related areas: (1) sources of organs for transplantation and various methods of transplants, including living donations, fetal tissue use, defining brain death, and nonhuman organ transfer; (2) policy, including presumed consent, required requests, and mandated choice to relieve the shortage problem; (3) the ethics of selling organs, the effect on supply and use of organs, making organ procurement a global effort; (4) case histories and questions on who should (not) receive transplants; and (5) the value

This collection of essays emphasizes society's increasingly responsible engagement with ethical challenges in emerging medical technology. Expansion of technological capacity and attention to patient safety have long been integral to improving healthcare delivery but only relatively recently have concepts like respect, distributive justice, privacy, and autonomy gained some power to shape the development, use, and refinement of medical tools and techniques. Medical ethics goes beyond making better medicine to thinking about how to make the field of medicine better. These essays showcase several ways in which modern ethical thinking is improving safety, efficacy and efficiency of medical technology, increasing access to medical care, and empowering patients to choose care that comports with their desires and beliefs. Included are complimentary ethical approaches as well as compelling counter-arguments. Together, the articles demonstrate how improving the quality of medical technology relies on every stakeholder -- not just medical researchers and scientists -- to assess each given technology's strengths and pitfalls. This collection also portends one of the next major issues in the ethics of medical technology: developing the requisite moral framework to accompany shifts toward patient-centred personalized healthcare.

Arthur L. Caplan It is commonly said, especially when the subject is assisted reproduction, that medical technology has out stripped our morality. Yet, as the essays in this volume make clear, that is not an accurate assessment of the situ ation. Medical technology has not overwhelmed our moral ity. It would be more accurate to say that our society has not yet achieved consensus about the complex ethical iss ues that arise when medicine tries to assist those who seek its services in order to reproduce. Nevertheless, there is no shortage of ethical opinion about what we ought to do with respect to the use of surrogate mothers, in vitro fertil ization, embryo transfer, artificial insemination, or fertil ity drugs. Nor is it entirely accurate to describe assisted repro duction as technology. The term "technology" carries with it connotations of machines buzzing and technicians scurrying about trying to control a vast array of equip ment. Yet, most of the methods used to assist reproduc tion that are discussed in this volume do not involve exotic technologies or complicated hardware. It is technique, more than technology, that dominates the field of assisted reproduction. Efforts to help the infertile by means of the manipu lation of human reproductive materials and organs date 1 2 Caplan back at least to Biblical times. Human beings have en gaged in all manner of sexual practices and manipulations in attempts to achieve reproduction when nature has balked at allowing life to begin.

hope of obtaining a comprehensive and coherent understand ing of the human condition, we must somehow weave together the biological, sociological, and psychological components of human nature and experience. And this cannot be done indeed, it is difficult to even make sense of an attempt to do it-without first settling our accounts with Darwin, Marx, and Freud. The legacy of these three thinkers continues to haunt us in other ways as well. Whatever their substantive philosophical differences in other respects, Darwin, Marx, and Freud shared a common, overriding intellectual orientation: they taught us to see human things in historical, developmental terms. Phil osophically, questions of being were displaced in their works by questions of becoming. Methodologically, genesis replaced teleological and essentialist considerations in the explanatory logic of their theories. Darwin, Marx, and Freud were, above all, theorists of conflict, dynamism, and change. They em phasized the fragility of order, and their abiding concern was always to discover and to explicate the myriad ways in which order grows out of disorder. For these reasons their theories constantly confront and challenge the cardinal tenet of our modern secular faith: the notion of progress. To be sure, their emphasis on conflict and the flux of change within the flow of time was not unprecedented; its origins in Western thought can be traced back at least as far as Heraclitus."

In April 1982, an infant boy was born in Bloomington, Indiana, with Down syndrome and a defective, but surgically correctable, esophagus. His parents refused to consent to surgery or intravenous feeding. The hospital unsuccessfully sought a court order to force treatment, and appeals to higher courts also failed. The child, identified as Baby Doe by the news media, subsequently died. The events in Bloomington became the catalyst for action by the Reagan administration, the courts, and Congress that culminated in a federal policy that makes failure to treat newborns with disabilities a form of child neglect. This book centers on the public policy aspects of withholding treatment from critically ill newborns who are disabled. Specifically, it deals with why the policy was enacted and what impact it has had on health care workers, families, and infants. Some of the contributors to this book spearheaded the early debate on withholding treatment. Anthony Shaw's New York Times Magazine article in 1972 was the first to address these issues in the popular press. The following year, he published a related article in the New England Journal of Medicine. Also appearing in this same issue of NEJM, was the pathbreaking study, coauthored by A. G. M. Campbell, on withholding treatment in the special care nursery at Yale-New Haven Hospital. Each of these articles promoted much public and professional discussion.

In When Medicine Went Mad, one of the nation's leading bioethicists-and an extraordinary panel of experts and concentration camp survivors-examine problems first raised by Nazi medical experimentation that remain difficult and relevant even today. The importance of these issues to contemporary bioethical disputes-particularly in the thorny areas of medical genetics, human experimentation, and euthanasia-are explored in detail and with sensitivity.

The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context."

In April 1982, an infant boy was born in Bloomington, Indiana, with Down syndrome and a defective, but surgically correctable, esophagus. His parents refused to consent to surgery or intravenous feeding. The hospital unsuccessfully sought a court order to force treatment, and appeals to higher courts also failed. The child, identified as Baby Doe by the news media, subsequently died. The events in Bloomington became the catalyst for action by the Reagan administration, the courts, and Congress that culminated in a federal policy that makes failure to treat newborns with disabilities a form of child neglect. This book centers on the public policy aspects of withholding treatment from critically ill newborns who are disabled. Specifically, it deals with why the policy was enacted and what impact it has had on health care workers, families, and infants. Some of the contributors to this book spearheaded the early debate on withholding treatment. Anthony Shaw's New York Times Magazine article in 1972 was the first to address these issues in the popular press. The following year, he published a related article in the New England Journal of Medicine. Also appearing in this same issue of NEJM, was the pathbreaking study, coauthored by A. G. M. Campbell, on withholding treatment in the special care nursery at Yale-New Haven Hospital. Each of these articles promoted much public and professional discussion.

Arthur L. Caplan It is commonly said, especially when the subject is assisted reproduction, that medical technology has out stripped our morality. Yet, as the essays in this volume make clear, that is not an accurate assessment of the situ ation. Medical technology has not overwhelmed our moral ity. It would be more accurate to say that our society has not yet achieved consensus about the complex ethical iss ues that arise when medicine tries to assist those who seek its services in order to reproduce. Nevertheless, there is no shortage of ethical opinion about what we ought to do with respect to the use of surrogate mothers, in vitro fertil ization, embryo transfer, artificial insemination, or fertil ity drugs. Nor is it entirely accurate to describe assisted repro duction as technology. The term "technology" carries with it connotations of machines buzzing and technicians scurrying about trying to control a vast array of equip ment. Yet, most of the methods used to assist reproduc tion that are discussed in this volume do not involve exotic technologies or complicated hardware. It is technique, more than technology, that dominates the field of assisted reproduction. Efforts to help the infertile by means of the manipu lation of human reproductive materials and organs date 1 2 Caplan back at least to Biblical times. Human beings have en gaged in all manner of sexual practices and manipulations in attempts to achieve reproduction when nature has balked at allowing life to begin."

The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context."

In these 25 true stories, a widely published philosopher recounts 60 years of interaction with people in all walks of life – some extremely famous, others complete strangers – from hospitals to restaurants, concert halls to airplanes, in private conversations and nationally broadcast interviews. Stories can be heartbreaking, distracting, funny, shocking, inspiring, revealing, and sometimes unforgettable – and all those attributes appear here. There’s no substitute for learning what it’s like to be someone else, to see the world as that other person does and reconsider our own views in light of that learning. These compelling and accessible stories motivate and enable us to do that, illuminating the unexpected relationships among all domains of human concern, the wellsprings of creativity, the elusive character of good judgment, and the pathways to social justice. They help us see more clearly what we care most about: deep features of human character and difficult choices, of social structures, of the power of imagination, of how to take account of the importance of what cannot be counted, and of bogus boundaries and assumptions that can repress clear thinking in any domain. These stories will make the reader more powerful in service of those values.

Internationally renowned medical scientist, frequent media contributor, and autism dad Dr. Peter J. Hotez explains why vaccines do not cause autism. In 1994, Peter J. Hotez's nineteen-month-old daughter, Rachel, was diagnosed with autism. Dr. Hotez, a pediatrician-scientist who develops vaccines for neglected tropical diseases affecting the world's poorest people, became troubled by the decades-long rise of the influential anti-vaccine community and its inescapable narrative around childhood vaccines and autism. In Vaccines Did Not Cause Rachel's Autism, Hotez draws on his experiences as a pediatrician, vaccine scientist, and father of an autistic child. Outlining the arguments on both sides of the debate, he examines the science that refutes the concerns of the anti-vaccine movement, debunks current conspiracy theories alleging a cover-up by the Centers for Disease Control and Prevention, and critiques the scientific community's failure to effectively communicate the facts about vaccines and autism to the general public, all while sharing his very personal story of raising a now-adult daughter with autism. A uniquely authoritative account, this important book persuasively provides evidence for the genetic basis of autism and illustrates how the neurodevelopmental pathways of autism are under way before birth. Dr. Hotez reminds readers of the many victories of vaccines over disease while warning about the growing dangers of the anti-vaccine movement, especially in the United States and Europe. Now, with the anti-vaccine movement reenergized in our COVID-19 era, this book is especially timely. Vaccines Did Not Cause Rachel's Autism is a must-read for parent groups, child advocates, teachers, health-care providers, government policymakers, health and science policy experts, and anyone caring for a family member or friend with autism. "When Peter Hotez-an erudite, highly trained scientist who is a true hero for his work in saving the world's poor and downtrodden-shares his knowledge and clinical insights along with his parental experience, when his beliefs in the value of what he does are put to the test of a life guiding his own child's challenges, then you must pay attention. You should. This book brings to an end the link between autism and vaccination."-from the foreword by Arthur L. Caplan, NYU School of Medicine

Discussions of key ethical dilemmas in mental health care, including consent, trauma and violence, addiction, confidentiality, and therapeutic boundaries. This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions. This book meets that need, providing foundational background for undergraduate, graduate, and professional courses. Topics include central questions such as evolving views of the morality and pathology of deviant behavior; patient competence and the decision to refuse treatment; recognizing and treating people who have suffered trauma; addiction as illness; the therapist's responsibility to report dangerousness despite patient confidentiality; and boundaries for the therapist's interaction with patients outside of therapy, whether in the form of tennis games, gift-giving, or social media contact. For the most part the selections address contemporary issues in contemporary terms, but the book also offers a few historic or classic essays, including Thomas S. Szasz's controversial 1971 article "The Ethics of Addiction." Contributors Laura Weiss Roberts, Frederic G. Reamer, Charles P. O'Brien, and Thomas McLellan

After the Nancy Cruzan case was decided by the Supreme Court in 1990, and ultimately resolved by the Courts of the State of Missouri, the decision to withhold or withdraw life-prolonging nutrition and hydration appeared to many to be as noncontroversial as decisions to refuse respirators or dialysis. Even the Catholic Church held that, although there should be a presumption in favor of providing nutrition and hydration, the patient or the patient's surrogate could overrule this presumption, if either believed the treatment was disproportionate or burdensome. The Schiavo case changed all that. Although the decision to remove Terri Schiavo's nutrition and hydration was made by her husband - her legal surrogate - based on his wife's belief that such treatment was disproportionate, Schiavo's immediate family protested so much that the case took years to resolve. It eventually involved all branches of government at both the state and federal levels. The ethical dilemmas that such cases pose continue to stir great controversy. This in-depth examination of these dilemmas provides information and documentation from many perspectives. The editors have included a foreword by Dr. Jay Wolfson, Terri Schiavo's court-appointed guardian ad litem, as well as Dr. Wolfson's report to Gov. Jeb Bush on the case and Gov. Bush's reply; public statements by President George Bush and Senators David Weldon, Rick Santorum, Tom DeLay, Bill Frist, and Barney Frank; statements by the pope and other representatives of the Catholic Church on this issue; plus much medical and legal background material on both precedents to the Schiavo case and its aftermath, including the results of the autopsy report. For anyone wishing an in-depth understanding of these complex ethical issues, issues many of us will have to confront in our own families, this volume is indispensable.

In When Medicine Went Mad, one of the nation's leading bioethicists-and an extraordinary panel of experts and concentration camp survivors-examine problems first raised by Nazi medical experimentation that remain difficult and relevant even today. The importance of these issues to contemporary bioethical disputes-particularly in the thorny areas of medical genetics, human experimentation, and euthanasia-are explored in detail and with sensitivity.

"An important contribution to a debate that will continue for sometime." -- Health and Canadian Society

"Insightful andthought-provoking.... As Caplan has demonstrated so clearly... we would all bebetter off if the ethicists spoke first and not last." -- The WashingtonPost

"Caplan's views are important and instructive.... [This]book represents some of his best work." -- New England Journal ofMedicine

"Caplan's [book] is thought provoking, insightful, and well argued. I recommend it highly." -- The Journal of the AmericanMedical Association

..". a generously illustrated discourseon method in medical and practical ethics." -- Ethics

Amember of the President's Task Force on National Health Care Reform examines some ofthe most controversial biomedical issues of our time.

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a system of fee-for-system medicine, better known as 'managed care.'"

The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time.

Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D.

This collection of essays examines the ways in which disputes and controversies about the application of scientific knowledge are resolved. Four concrete examples of public controversy are considered in detail: the efficacy of Laetrile, the classification of homosexuality as a disease, the setting of safety standards in the workplace, and the utility of nuclear energy as a source of power. The essays in this volume show that debates about these cases are not confined to matters of empirical fact. Rather, as is seen with most scientific and technical controversies, they focus on and are structured by complex ethical, economic, and political interests. Drs. Engelhardt and Caplan have brought together a distinguished group of scholars from the sciences and humanities, who sketch a theory of scientific controversy and attempt to provide recommendations about the ways in which both scientists and the public ought to seek more informed resolutions of highly contentious issues in science and technology. Scientific Controversies is offered as a contribution to the better understanding of the roles of both science and nonscientific interests in disputes and controversies pertaining to science and technology.