Modern psychological and political theory meet head-on in this powerful re-evaluation of America's contradictory and sometimes dangerous addiction to individualism. Best-selling author Gaylin and co-author Jennings investigate the contentious intersections of interdependence and autonomy, rights and public responsibility. They examine the painful abrasion occurring between America's tradition of personal freedom and privacy, as it rubs against the still valuable if almost vanishing ideals of sacrifice and social order.

Our current culture of autonomy -- championed by both liberals on the left and libertarians on the right -- is based on the idea of rationality as the motivation for human conduct. But, as the authors remind us, people are not simply rational creatures -- appeals to emotions are always far more effective than logical argument in changing our behavior.

This timely edition includes a new preface; updated examples and illustrations throughout; and new coverage of contemporary social critics and their work since the publication of the first edition. Two essential new chapters, one on the movement to forgo life-sustaining treatment and the other on physician-assisted suicide, particularly clarify the authors' arguments. Drawing on these and numerous other illustrations -- with significant emphasis on the state of American health care -- Gaylin and Jennings demonstrate that society has not just the right but the "duty" to occasionally invoke fear, shame, and guilt in order to motivate humane behavior.

As cases of AIDS are once again on the upswing, as the dangerously mentally ill are allowed to wander free and untreated, as starvation and poverty still hold too many in its grip in the richest nation on the planet, this controversial book, considerably revised and expanded, is needed more than ever. If we are to indeed preserve and nurture a genuinely free -- and liberal -- society, the authors suggest that these "coercions" may be essential for the health and the maturity of a nation where we all too often avert our eyes, not seeing that our neighbor is in pain or trouble and needs our help.

The Collaborative for Palliative Care ("Collaborative") is a grassroots consortium of public and private organizations that came together in 2005 for the purposes of studying the increasing need for palliative care and the methods for such care. It has grown from a small fledgling group to a membership of over 50 community-based organizations and volunteers dedicated to improving care of the seriously ill through education, research and advocacy. The Collaborative bridges policy, research and practice in its initiatives and vision for the future. Partners in Palliative Care examines specific areas of concern that the Collaborative has addressed in its education programs and advocacy, as well as the collaborative processes that have been so successful in building community assets. Areas of concentration have been diverse and include advance care planning, relational communication paradigms, community capacity building, the role of culture and spirituality in palliative care, the meaning of pain and suffering for seriously ill individuals, and the ethics of health care costs in palliative and end-of-life systems of care. This book was originally published as a special issue of the Journal of Social Work in End-of-Life and Palliative Care.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America's project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

The philanthropist and philosopher Strachan Donnelley (1942--2008) devoted his life to studying the complex relationship between humans and nature. Founder and first president of the Center for Humans and Nature, Donnelley was a pioneer in the exploration and promotion of the idea that human beings individually and collectively have moral and civic responsibilities to natural ecosystems. In this wide-ranging volume, Donnelley traces the connections between influential figures such as Aldo Leopold and Charles Darwin, as well as lesser-known but original thinkers that he met during the course of a full life -- ministers at his church, friends with whom he fished, and colleagues who shared his passion for research and writing. He grounds his work in classic philosophers such as Descartes, Spinoza, and Whitehead and reinterprets their writings about the natural world to develop a conservation-centered philosophy, which he dubs "democratic ecological citizenship." Edited by his daughter, Ceara Donnelley, and Bruce Jennings, Frog Pond Philosophy illuminates the dominant strands of Donnelley's intellectual identity as a philosopher, naturalist, agitator, and spiritualist. Despite his often grim depiction of the current state of the environment, Donnelly never surrenders his faith in humanity's ability to meet its ethical obligations to conserve, respect, and nurture the complexity and diversity of the natural world. His vivid and personal essays, rooted in everyday experiences, offer a distinctive perspective on questions of urgent contemporary importance.

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise."

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."

This book examines the concept of liberty in relation to civilization's ability to live within ecological limits. Freedom, in all its renditions - choice, thought, action - has become inextricably linked to our understanding of what it means to be modern citizens. And yet, it is our relatively unbounded freedom that has resulted in so much ecological devastation. Liberty has piggy-backed on transformations in human-nature relationships that characterize the Anthropocene: increasing extraction of resources, industrialization, technological development, ecological destruction, and mass production linked to global consumerism. This volume provides a deeply critical examination of the concept of liberty as it relates to environmental politics and ethics in the long view. Contributions explore this entanglement of freedom and the ecological crisis, as well as investigate alternative modernities and more ecologically benign ways of living on Earth. The overarching framework for this collection is that liberty and agency need to be rethought before these strongly held ideals of our age are forced out. On a finite planet, our choices will become limited if we hope to survive the climatic transitions set in motion by uncontrolled consumption of resources and energy over the past 150 years. This volume suggests concrete political and philosophical approaches and governance strategies for learning how to flourish in new ways within the ecological constraints of the planet. Mapping out new ways forward for long-term ecological well-being, this book is essential reading for students and scholars of ecology, environmental ethics, politics, and sociology, and for the wider audience interested in the human-Earth relationship and global sustainability.

This book examines the concept of liberty in relation to civilization's ability to live within ecological limits. Freedom, in all its renditions - choice, thought, action - has become inextricably linked to our understanding of what it means to be modern citizens. And yet, it is our relatively unbounded freedom that has resulted in so much ecological devastation. Liberty has piggy-backed on transformations in human-nature relationships that characterize the Anthropocene: increasing extraction of resources, industrialization, technological development, ecological destruction, and mass production linked to global consumerism. This volume provides a deeply critical examination of the concept of liberty as it relates to environmental politics and ethics in the long view. Contributions explore this entanglement of freedom and the ecological crisis, as well as investigate alternative modernities and more ecologically benign ways of living on Earth. The overarching framework for this collection is that liberty and agency need to be rethought before these strongly held ideals of our age are forced out. On a finite planet, our choices will become limited if we hope to survive the climatic transitions set in motion by uncontrolled consumption of resources and energy over the past 150 years. This volume suggests concrete political and philosophical approaches and governance strategies for learning how to flourish in new ways within the ecological constraints of the planet. Mapping out new ways forward for long-term ecological well-being, this book is essential reading for students and scholars of ecology, environmental ethics, politics, and sociology, and for the wider audience interested in the human-Earth relationship and global sustainability.

The Collaborative for Palliative Care ("Collaborative") is a grassroots consortium of public and private organizations that came together in 2005 for the purposes of studying the increasing need for palliative care and the methods for such care. It has grown from a small fledgling group to a membership of over 50 community-based organizations and volunteers dedicated to improving care of the seriously ill through education, research and advocacy. The Collaborative bridges policy, research and practice in its initiatives and vision for the future. Partners in Palliative Care examines specific areas of concern that the Collaborative has addressed in its education programs and advocacy, as well as the collaborative processes that have been so successful in building community assets. Areas of concentration have been diverse and include advance care planning, relational communication paradigms, community capacity building, the role of culture and spirituality in palliative care, the meaning of pain and suffering for seriously ill individuals, and the ethics of health care costs in palliative and end-of-life systems of care. This book was originally published as a special issue of the Journal of Social Work in End-of-Life and Palliative Care.

As our economic and natural systems continue on their collision course, Bruce Jennings asks whether we have the political capacity to avoid large-scale environmental disaster. Can liberal democracy, he wonders, respond in time to ecological challenges that require dramatic changes in the way we approach the natural world? Must a more effective governance be less democratic and more autocratic? Or can a new form of grassroots ecological democracy save us from ourselves and the false promises of material consumption run amok? Ecological Governance is an ethicist's reckoning with how our political culture, broadly construed, must change in response to climate change. Jennings argues that during the Anthropocene era a social contract of consumption has been forged. Under it people have given political and economic control to elites in exchange for the promise of economic growth. In a new political economy of the future, the terms of the consumptive contract cannot be met without severe ecological damage. We will need a new guiding vision and collective aim, a new social contract of ecological trusteeship and responsibility.

As our economic and natural systems continue on their collision course, Bruce Jennings asks whether we have the political capacity to avoid large-scale environmental disaster. Can liberal democracy, he wonders, respond in time to ecological challenges that require dramatic changes in the way we approach the natural world? Must a more effective governance be less democratic and more autocratic? Or can a new form of grassroots ecological democracy save us from ourselves and the false promises of material consumption run amok? Ecological Governance is an ethicist's reckoning with how our political culture, broadly construed, must change in response to climate change. Jennings argues that during the Anthropocene era a social contract of consumption has been forged. Under it people have given political and economic control to elites in exchange for the promise of economic growth. In a new political economy of the future, the terms of the consumptive contract cannot be met without severe ecological damage. We will need a new guiding vision and collective aim, a new social contract of ecological trusteeship and responsibility.

All manner of medical practitioners have had their scruples dissected ad infinitum. In spite of the attention paid to medical ethics and bioethics, little has been paid to the ethical roles and responsibilities of those who are ultimately in charge of hospital governance: hospital trustees. Deriving from a Hastings Center research project involving meetings with a national task force of experts and extensive interviews with 98 nonprofit hospital trustees and CEOs over a two-year period, The Ethics of Hospital Trustees shows that the decisions made by these often overlooked members of the health community do raise important ethical issues, and that ethical dimensions of trustee service should be more explicitly recognized and discussed.Practical as well as theoretical, The Ethics of Hospital Trustees uncovers four basic principles: 1. Fidelity to mission; 2. Service to patients; 3. Service to the community; and 4. Institutional stewardship. In delineating the extremely important functions of hospital trustees, from patient safety to financial responsibility, the contributors outline not only how hospital trustees do perform -- they give a fresh understanding to how they should perform as well.

Long-acting and reversible contraceptives, such as Norplant and Depo-Provera, have been praised as highly effective, moderately priced, and generally safe. Yet, as this book argues, the very qualities that make these contraceptives an important alternative for individual choice in family planning also make them a potential tool of coercive social policy. For example, policymakers have linked their use to welfare benefits, and judges, to probation agreements. In this book, authors from the fields of medicine, ethics, law, and the social sciences probe the unique and vexing ethical and policy issues raised by long-acting contraception. The book offers comprehensive ethical guidelines for health care professionals and policymakers, as well as an ethical framework for analyzing policies and practices concerning long-acting contraceptives. The authors consider cultural, social, and ethical issues pertaining to contraception, and they provide historical and scientific background on today's controversies. They explore alternative conceptual and theoretical frameworks, including analyses of autonomy, coercion, and responsibility in reproductive decisions. This volume also notes the special concerns that arise when policies promoting long-term birth control target low-income women and women of color, and when these contraceptives are used in developing countries.

Emergency Ethics brings together leading scholars in the fields of public health ethics and bioethics to discuss disaster or emergency ethics and ethical aspects of preparedness and response with specific application to public health policy and practice. The book fills a gap in the existing public health ethics literature by providing a comprehensive ethical conception of emergency preparedness as a distinctive form of civic "practice " brought about by the interrelationships and coordination of many groups, disciplines, and interests and drawing on numerous bodies of knowledge and expertise. It addresses particular aspects of preparedness and response plans, particular decisions that planners and communities have to make, decisions that require balancing many diverse and sometimes conflicting values and identifying and applying a framework of basic ethical principles for preparedness planning, emergency response, and post-disaster recovery. It also explores the relationship between emergency preparedness to other facets of public health practice. The book begins with a broad and synthetic overview of emergency ethics that addresses the central components and ethically significant issues arising in public health preparedness planning, disaster response, and recovery. Following that overview are five chapters that in a philosophically innovative and detailed way delve deeply into important and problematic issues in emergency planning and response, including the allocation of scarce resources, conducting ethical research in the context of public health emergencies, the obligations of public health professionals, communication and engagement with the public, and special moral obligations surrounding vulnerable populations.

Since public health seeks to protect the health of populations, it inevitably confronts a range of ethical challenges having to do primarily with the friction between individual freedoms and what might be perceived as governmental paternalism. This volume brings together twenty-five articles by leading thinkers in the field, writing on topics that concern both classic and novel problems. They open up new terrain in each area, including tobacco and drug control, infectious disease, environmental and occupational health, the effect of new genetics on the publics health, and the impact of social inequalities on patterns of morbidity and mortality. The volume editors offer a context for discussion with introductory essays for each of the books five sections.

Hospice care is one of the fastest-growing segments of the U. S. healthcare system, a trend that is expected to accelerate as the median age of the population continues to rise over the next three decades. Despite over forty percent of the population now dying while on hospice care, very little has been published on the ethical opportunities and challenges experienced in the everyday lives of those giving and receiving hospice care. This book is the first comprehensive collection devoted to analyzing distinctive ethical issues arising in the delivery of hospice care and designed to promote best ethical practices for hospice care professionals and organizations. Thirteen newly commissioned chapters by seventeen hospice experts populate three thematic sections of the book, each devoted to an aspect of the intersection between ethics and hospice care. Contributors have unique qualifications and abilities to articulate and respond to ethically significant phenomena that - while not always unique to hospice care - arise in especially poignant and complex ways when caring for patients enrolled in hospice. As the shift or return to home-based care at the end of life continues, hospice professionals and programs will be faced with a broader array of terminal illnesses, cultural beliefs and traditions, and patient and family values than ever before. Hospice will no longer be tailored solely to the final stage of cancer, but will need to accommodate patients whose illnesses are variable in their progression and whose treatment plans include many medical options. The ethical orientations and frameworks that have served hospice for the past 50 years will need to be supplemented and refined if hospice is to fulfill this changing social mission. Hospice Ethics explores a new paradigm for hospice ethics from a multi-disciplinary and provides an important educational resource for professional training in end of life care.