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Before a separate Department of Medical Humanities was formed, the
editors of this volume were faculty members of the Department of
Pediatrics at our medical school. Colleagues daily spoke of the
moral and social problems of children's health care. Our offices
were near the examining rooms where children had their bone-marrow
procedures done. Since this is a painful test, we often heard them
cry. The hospital floor where the sickest children stayed was also
nearby. The physicians, nurses, and social workers believed that
children's health care needs were not being met and that more could
and should be done. Fewer resources are available for a child than
for an adult with a comparable illness, they said. These
experiences prompted us to prepare this volume and to ask whether
children do get their fair share of the health care dollar. Since
the question "What kind of health care do we owe to our children?"
is complex, responses should be rooted in many disciplines. These
include philosophy, law, public policy and, of course, the health
professions. Representing all of these disciplines, contributors to
this volume reflect on moral and social issues in children's health
care. The last hundred years have brought great changes in health
care tor children. The specialty of pediatrics developed during
this period, and with it, a new group of advocates for children's
health care. Women's suffrage gave a political boost to the
recognition of children's special health needs.
The expense of critical care and emergency medicine, along with
widespread expectations for good care when the need arises, pose
hard moral and political problems. How should we spend our tax
d'ollars, and who should get help? The purpose of this volume is to
reflect upon our choices. The authors whose papers appear herein
identify major difficulties and offer various solutions to them.
Four topics are discussed throughout the volume: First, encounters
between patients and health professionals in critical situations in
general, and where scarcity makes rationing necessary; second,
allocation and social policy, including how much to spend on
preventive, chronic or critical care medicine, or for medicine in
general compared to other important social projects; third,
conflicts between or ranking of important goals and values; and
fourth, conceptual issues affecting the choices we make. Since
these topics are raised by the authors in almost every essay, we
did not divide the papers into separate sections within the volume.
Warren Reich begins the volume with a parable illustrating a key
problem for contemporary medicine and two very different approaches
to its solution. His story begins with the "delivery" of three
indigent, critically ill, foreign patients to the emergency room of
a large American private hospital. Although the hospital is legally
bound to care for these patients, providing long term, high cost
care for them and others soon becomes a major financial strain.
This volume offers a collection of writings on ethical issues
regarding retarded persons. Because this important subject has been
generally omitted from formal discussions of ethics, there is a
great deal which needs to be addressed in a theoretical and
critical way. Of course, many people have been very concerned with
practical matters concerning the care of retarded persons such as
what liberties, entitlements or advocacy they should have.
Interestingly, because so much practical attention has been given
to issues which are not discussed by ethical theorists, they offer
a rare opportunity to evaluate ethical theories themselves. That
is, certain theories which appear convincing on other subjects seem
implausible when they are applied to reasoned and com pelling views
we hold concerning retarded individuals. Our subject, then, has
both practical and conceptual dimensions. More over, because it is
one where pertinent information comes from many sources,
contributors to this volume represent many fields, including
philosophy, religion, history, law and medicine. We regret that it
was not possible to include more points of view, like those of
psychologists, sociologists, nurses and families. There is however,
a good and longstanding literature on mental retardation from these
perspectives."
K. Danner Clouser is one of the most important figures in
establishing and shaping the fields of medical ethics, bioethics,
and the philosophy of education in the second half of the twentieth
century. Clouser challenged many established approaches to moral
theory and offered innovative strategies for integrating the
humanities into professional education, especially that of
physicians and nurses. The contributions published in Building
Bioethics: Conversations with Clouser and Friends on Medical Ethics
are unique both in their devotion to a critical review of his
contributions, and in bringing together internationally known
figures in bioethics, medical ethics, and philosophy of medicine to
comment upon Clouser's work. These leaders of the field include Tom
Beauchamp, Daniel Callahan, James Childress, Nancy Dubler, H.
Tristram Engelhardt, Al Jonsen, Loretta Kopelman, Larry McCullough,
John Moskop, and Robert Veatch. This book merits special attention
from those interested in bioethics, philosophy of medicine, medical
ethics, philosophy, medical education, religious studies, and
nursing education.
K. Danner Clouser is one of the most important figures in
establishing and shaping the fields of medical ethics, bioethics,
and the philosophy of education in the second half of the twentieth
century. Clouser challenged many established approaches to moral
theory and offered innovative strategies for integrating the
humanities into professional education, especially that of
physicians and nurses. The contributions published in Building
Bioethics: Conversations with Clouser and Friends on Medical Ethics
are unique both in their devotion to a critical review of his
contributions, and in bringing together internationally known
figures in bioethics, medical ethics, and philosophy of medicine to
comment upon Clouser's work. These leaders of the field include Tom
Beauchamp, Daniel Callahan, James Childress, Nancy Dubler, H.
Tristram Engelhardt, Al Jonsen, Loretta Kopelman, Larry McCullough,
John Moskop, and Robert Veatch. This book merits special attention
from those interested in bioethics, philosophy of medicine, medical
ethics, philosophy, medical education, religious studies, and
nursing education.
Before a separate Department of Medical Humanities was formed, the
editors of this volume were faculty members of the Department of
Pediatrics at our medical school. Colleagues daily spoke of the
moral and social problems of children's health care. Our offices
were near the examining rooms where children had their bone-marrow
procedures done. Since this is a painful test, we often heard them
cry. The hospital floor where the sickest children stayed was also
nearby. The physicians, nurses, and social workers believed that
children's health care needs were not being met and that more could
and should be done. Fewer resources are available for a child than
for an adult with a comparable illness, they said. These
experiences prompted us to prepare this volume and to ask whether
children do get their fair share of the health care dollar. Since
the question "What kind of health care do we owe to our children?"
is complex, responses should be rooted in many disciplines. These
include philosophy, law, public policy and, of course, the health
professions. Representing all of these disciplines, contributors to
this volume reflect on moral and social issues in children's health
care. The last hundred years have brought great changes in health
care tor children. The specialty of pediatrics developed during
this period, and with it, a new group of advocates for children's
health care. Women's suffrage gave a political boost to the
recognition of children's special health needs.
The expense of critical care and emergency medicine, along with
widespread expectations for good care when the need arises, pose
hard moral and political problems. How should we spend our tax
d'ollars, and who should get help? The purpose of this volume is to
reflect upon our choices. The authors whose papers appear herein
identify major difficulties and offer various solutions to them.
Four topics are discussed throughout the volume: First, encounters
between patients and health professionals in critical situations in
general, and where scarcity makes rationing necessary; second,
allocation and social policy, including how much to spend on
preventive, chronic or critical care medicine, or for medicine in
general compared to other important social projects; third,
conflicts between or ranking of important goals and values; and
fourth, conceptual issues affecting the choices we make. Since
these topics are raised by the authors in almost every essay, we
did not divide the papers into separate sections within the volume.
Warren Reich begins the volume with a parable illustrating a key
problem for contemporary medicine and two very different approaches
to its solution. His story begins with the "delivery" of three
indigent, critically ill, foreign patients to the emergency room of
a large American private hospital. Although the hospital is legally
bound to care for these patients, providing long term, high cost
care for them and others soon becomes a major financial strain.
This volume offers a collection of writings on ethical issues
regarding retarded persons. Because this important subject has been
generally omitted from formal discussions of ethics, there is a
great deal which needs to be addressed in a theoretical and
critical way. Of course, many people have been very concerned with
practical matters concerning the care of retarded persons such as
what liberties, entitlements or advocacy they should have.
Interestingly, because so much practical attention has been given
to issues which are not discussed by ethical theorists, they offer
a rare opportunity to evaluate ethical theories themselves. That
is, certain theories which appear convincing on other subjects seem
implausible when they are applied to reasoned and com pelling views
we hold concerning retarded individuals. Our subject, then, has
both practical and conceptual dimensions. More over, because it is
one where pertinent information comes from many sources,
contributors to this volume represent many fields, including
philosophy, religion, history, law and medicine. We regret that it
was not possible to include more points of view, like those of
psychologists, sociologists, nurses and families. There is however,
a good and longstanding literature on mental retardation from these
perspectives."
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