The Journal of Medical Ethics has published a few papers over recent years that explore the ethical implications of ectogenesis.1–4 It is an as yet undeveloped but theoretically possible method by which a fetus can be gestated outside of the womb, and while the prospects of ‘full’ ectogenesis seem some way off, there are techniques that suggest ‘partial’ ectogenesis could be closer. This issue’s Feature Article considers two of the principal arguments that have been developed in favour of (...) ectogenesis being permissible and available.5 Cavaliere observes that the equality and freedom promoting aspects of ectogenesis will only benefit a small number of women, and she argues that it’s the broader political perspective ectogenesis advances that’s valuable. By equality she has in mind the workplace, the burdens of bearing, as well as equality among fertile, infertile, trans and lesbian women. In this context, …. (shrink)

A unique relationship exists between physicians and philosophers — one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the (...) social cultural and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary. (shrink)

Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort (...) of details that should be included in the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of generality, i.e. a political understanding of context. (shrink)

Ethnomedicine is the field that analyzes medical traditions comparatively. An ethnomedical approach is used in the essay to analyze the topic of medical ethics. General properties of medical ethics as realized in different societies are outlined. These pertain to the healer's relations with clients, with other healers, and with the group or society. The conditions of medical practice and the influence of social and political factors that affect them are discussed in relation to (...) medical ethical questions. Unique developments of contemporary medical science that affect and condition practice and raise new ethical questions are examined in light of ethnomedical generalizations. The essay aims to clarify the cultural bases of medicine generally and ethical aspects of medical practice and care more specifically. (shrink)

This article examines a population-based opportunistic screening practice for cognitive impairment that takes place at a hospital in Sweden. At the hospital, there is a routine in place that stipulates that all patients over the age of 65 who are admitted to the ward will be offered testing for cognitive impairment, unless they have been tested within the last six months or have been diagnosed with any form of cognitive impairment. However, our analysis shows that this routine is not universally (...) and mechanically applied. Rather, the health care professionals have developed and use an ethico-political judgment, concerning, for example,whomto test,whento offer the tests, andhowto explain and perform them. This article explores the role and practice of this form of judgment, emphasising its political and ethical nature. The analysis is based on qualitative interviews with professionals and patients, and draws on the theories of Aristotle and Hannah Arendt. (shrink)

The meaning of justice can be defined according to a juridical, human, theological, ethical, biomedical, or social perspective. It should guarantee the protection of life and health, personal, civil, political, economic, and religious rights, as well as non-discrimination, inclusion, protection, and access to care. In this review, we deal with three theoretical concepts that define justice in all its aspects. (1) The utilitarian theory, which justifies moral statements on the basis of the evaluation of the consequences that an (...) action produces, elaborating a pragmatic model of medical science. (2) The libertarian theory, which considers freedom as the highest political aim, thus absolutizing the rights of the individual; here, the principle of self-determination, with respect to which the principle of permission/consent is the fundamental presupposition, plays a central role in the definition of the person. (3) The iusnaturalist theory, in which man’s moral freedom is identified with the ability to act by choosing what the intellect indicates to him as good; the natural moral law that drives every conscience to do good is therefore realized in respect for the person in the fullness of his rights. In conclusion, different forms and conceptions of justice correspond to different organizations of society and different ways of addressing ethical issues in the biomedical domain. (shrink)

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff (...) seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record. (shrink)

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and (...) the responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades. (shrink)

This book examines the extremely important issue of the consistency of medical involvement in ending lives in medicine, law and war. It uses philosophical theory to show why medical doctors may be involved at different stages of the capital punishment process. The author uses the theories of Emmanuel Kant and John S. Mill, combined with Gerwith's principle of generic consistency, to concretize ethics in capital punishment practice. This book does not discuss the moral justification of capital punishment, (...) but rather looks at the possible forms of involvement and shows why consistency would demand medical involvement. The author takes a general approach, using arguments that may apply universally. The book broaches different academic fields, such as medicine, ethics, business, politics and defense. The Ethics of Medical Involvement in Capital Punishment is of interest to students, teachers, lecturers and researchers working in the areas of capital punishment, medical, legal and business ethics, and political philosophy. (shrink)

This book focuses on experimentation that is carried out on human beings, including medical research, drug research and research undertaken in the social sciences. It discusses the ethics of such experimentation and asks the question: who defends the interests of these human subjects and ensures that they are not harmed? The author finds that ethical research depends on the adequacy of review by committee. Indeed most countries now rely on research ethics committees for the protection of the (...) interests of the human participants in research. Dr McNeill analyses how successful these committees are in balancing the interests of science with the interests of human subjects. (shrink)

The concept of community is increasingly the focus of political argument in Britain, the United States and elsewhere around the world. The sense people have of belonging to coummunities provides a powerful motivation which continues to affecct the political and social face of the world. Recently, debate about the relationship between individuals and their communities has become central to the making of both, American and European social policy. In the United Kingdom this is especially apparent in the area (...) of health care, where ideas of community have informed recent legislation concerning community care, community health trusts and the Children Act among others. This volume explores the focus of interest in community and the emerging theoretical oppostion between communitarianism and liberalism, as well as the practical, theoretical and ethical issues relating to community in the health care professions, including a discussion of the health service as Civil Association, an analysis of liberal and communitarian views on the allocaiton of health care resources, an exploration of the use of genetic information and an examination of health care decision making for incapacitated elderly patients. (shrink)

Bioethics as politics -- Bioethics and the politics of expectations -- Engendering consent : bioethics and biobanks -- Missing the big picture : bioethics and stem cell research -- Testing times : bioethics and "do-it-yourself" genetics -- Governing uncertainty : the politics of nanoethics -- Beyond bioethics.

Although statistically common, and legal since 1973, abortion still bears significant stigma--a proverbial scarlet A. Fear of this stigma leads most of the women and men who are part of the 21% of American pregnancies that end in abortion to remain silent. This book brings the story of ordinary abortion out of the shadows and invites a new conversation about its actual practice, ethics, politics, and law. Katie Watson lends her incisive legal and medical ethics expertise to (...) navigate wisely and respectfully one of the most divisive topics of contemporary life. (shrink)

If biotechnology can be used to "upgrade" humans physically and mentally, should it be done? And if so, to what extent? How will biotechnology affect societal cohesion, and can the development be controlled? Or is this a Pandora's box that should remain closed? These are just a few of the many questions that arise as a result of the increasing ability of technology to change biology and, eventually, transform human living conditions. This development has created a new horizon of a (...) posthuman future that will influence contemporary life and politics in a number of ways. The book gathers researchers within the fields of biotechnology, medicine, ethics, politics, and aesthetics. Among the contributors are Francis Fukuyama, Julian Savulescu, Maxwell Mehlman, Lone Frank and Chris Hables Gray. (shrink)

This book explores the making of health care rationing decisions through the analysis of three alternative decision makers: patients paying out of pocket; officials setting limits on treatments and coverage; and physicians at the bedside. Hall develops this analysis along three dimensions: political economics, ethics, and law. The economic dimension addresses the practical feasibility of each method. The ethical dimension discusses the moral aspects of these methods, while the legal dimension traces the most recent developments in jurisprudence (...) and health law. (shrink)

Focusing on the shared sense of victimization and disadvantage-ness by both patients and doctors/medical workers in cases of medical conflicts, this paper aims to examine the current patient-doctor tensions in the larger context of moral transformation in Chinese society since the 1980s. Although the decline of public trust in certain aspects is closely associated with the impact of commodification and commercialization of medical sector during the past two decades, other factors play important role as well. In (...) the case of patient-doctor tension, mutual disrespect and mistrust also result from the ongoing process of individualization and the remaking of moral self, in which the individual demand for respect, dignity, and trust seem to have unexpectedly and ironically contributed to the rise of tensions and conflicts between patients and doctors as well as other medical workers. (shrink)

In this work, Colleen Clements presents her case for the need to subject the field of bioethics to a critical external analysis apart from the current postmodern assumptions. Clements argues that, since the 1970s, bioethics has refuted human values in favour of political consensus building. This failure to recognize basic human values in the ethical critique of modern medicine has lead to a dehumanization of the medical system by the field. Clements proceeds to advocate a naturalistic theory of (...) bioethics that reinstates primary human values. (shrink)

Every successful health care system should be based on some general humanistic ideals. However, the nationally organized health care systems of most European countries usually suffer from a deficiency in common ethical values based on universal human principles. When transitional societies, such as that of Bosnia-Herzegovina are concerned, health care organizational models are even more dysfunctional. The sources of a dysfunction in medical care system of Bosnia-Herzegovina are manifold and mutually controversial, including a lack of shared principles, an inappropriate (...) involvement of politicians in medical care and practice, administrative difficulties arising from superficial communication systems, as well as economic limits concerned with the financing of health care. The deficiency of a moral culture of medicine, which is correlated to a general collapse of morality is also responsible for many problems affecting various aspects of life including medical care. Hence, medical ethics from a virtue perspective is becoming an important ingredient of any improvement deigned to provide better-quality medical care. The aim of this paper is to underline the influence of humanism on the organization of health care systems and the ethics of medical interrelations in the society of Bosnia-Herzegovina. It is not intended to diagnose or resolve the problems, but to analyze them. It is also a critique of specific socio-political-economic influences on this health care system, inquiring if well-educated individuals in the virtues, which are involved in medical practice and education, would counteract them. In conclusion, humanism creates a universal ethical structure, which is based on human values such as fidelity, trust, benevolence, intellectual honesty, courage, compassion and truthfulness. These values should represent the standard around which medical care is organized. Since the health care system in Bosnia-Herzegovina is not entirely founded upon humanistic ideals, addressing the socio-political-economic conditions that constantly undermine those values is a prerequisite for any much-needed improvements of the medical care. (shrink)

Although euthanasia is seen as the problem of the individual will and as one’s right to privacy, to a better quality of life or to a dignified death, it has major institutional implications. They are closely related to the juridical system, to the way of understanding state involvement in protecting the individuals and respecting their freedoms, to the institutional system of health care, to the government rules that establish social, political or professional practices. The public debate around the topics (...) related to the human condition, like euthanasia, grants a special force to public communication, to organizational communication, to communication in professional environments, to physician-patient communication and, more generally, to interpersonal communication. In this text we emphasize the importance of public debate on euthanasia from the perspective of organizational ethics, of medical deontology, of patients’ rights, but especially of elaborating public policies and national programs, and we underline the importance of the need to establish protocols for health care, as well as to build a framework of democratic communication. (shrink)

This book treats practical and political reasoning as an active engagement with the world and other people; it cannot be understood as exclusively cognitive and this is seen as a virtue rather than a deficiency. Informal, emotional, characterological, aesthetic and interactional aspects of thought can be constituents of reasonable arguing. The work examines key capacities connected with argumentation, in a variety of fields from professional and medical ethics to work organization and the practice of art.

That they are ‘following the science’ has become the watchword of many politicians during the present pandemic, especially when imposing or prolonging lockdowns or other liberty-restricting regulations. The scientists who advise politicians however are usually careful to add that the decision what to restrict and when is ultimately a political one. In science, as in medical practice, there is a delicate balance to be maintained between confidence in the best available information, and the necessary caveat that the assumptions (...) and calculations on which that information is based are subject to further scientific enquiry. For politicians and the public, moreover, as for patients, whether those informing them are judged to be trustworthy is a necessary consideration, a judgement determined by a variety of personal and political contingencies and circumstances. Ethics, by contrast, unable to appeal to scientific consensus or political authority, let alone a confidence-inspiring bedside manner, must rest the case for its essentially contestable assumptions and arguments being judged trustworthy, on its willingness to admit all reasoned voices to a conversation that is potentially unending, but in the process often highly enlightening. That conversation is contributed to in this issue of the Journal by several reasoned voices, mostly on ethical aspects of the COVID-19 pandemic. Relevant to issues on which politicians claim to be ‘following the science’, but also raising fundamental ethical questions, is this month’s feature article. In Ethics of Selective Restriction of Liberty in a Pandemic, 1 Cameron and colleagues consider ‘if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups [for example, the elderly in COVID-19] of the community from contracting the disease’ [and thereby, for example, increasing …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Is Bioethics Applied Ethics?Robert M. VeatchBioethics is often referred to as a kind of applied ethics. The term applied ethics can be controversial if it is taken to imply that ethical theory from philosophy or religious ethics has to be the starting point for ethical analysis of some practical field such as medicine or law or politics. The term can be understood as requiring some (...) premises from an ethical theory that are then "applied" to some problem area, as a "top down" way of doing the work of moral reflection in a way that axioms in geometry are applied to present proofs of mathematical claim.The publication of an important work in the history of medical ethics, A History of Medical Ethics, provides an opportunity to reflect more carefully on what applied ethics means. That massive multi-authored volume edited by Robert Baker and Laurence McCullough (2007) is scheduled for publication this fall. With the permission of the Press, we have asked Baker and McCullough to prepare an article-length version of one of the central essays in that work. Their paper challenges the idea that ethical theory should be "applied" to medicine or other fields, putting forth an alternative of the "appropriation" of an ethical theory by the formulation of concepts, principles, moral rules, or other specifications that may turn out to be unique or at least modified for the particular field in question.In this issue of the Kennedy Institute of Ethics Journal, we publish the Baker-McCullough article together with five critical commentaries. We include two medical historians who have a sustained commitment to studying the history of ethics in medicine, two systematic ethicists who have an unusual level of commitment to studying ethics historically, and a physician with unusual sensitivity to the history of medical ethics. Each comments on the Baker-McCullough thesis and offers an alternative view of the link between ethical theory and the field of biomedical ethics.Daniel Fox triggered some of the initial reflection on the history of medical ethics in the 1970s. His work is discussed by Baker and McCullough. Fox is sympathetic with the Baker-McCullough appropriation thesis, viewing their position as complementary to his own, although he [End Page 1] urges more attention to the political aspects of medicine, professional dominance, and professional control of medical resources.Ulf Schmidt, a specialist on the historical aspects of research during the Nazi era, focuses on Baker and McCullough's use of that historical example of the appropriation of medical ethics.The two ethicists who comment both have had many years experience with historical aspects of medical ethics, and both worked on the historically important Belmont Report of the National Commission for the Protection of Human Subjects. Both question whether Baker and McCullough overstate the problem of the relation between application and appropriation. Albert Jonsen, as a member of the National Commission, concentrates on the Belmont Report, showing how he sees the report appropriating philosophical ethics.Tom Beauchamp, who was the primary staff person responsible for the report, provides a somewhat different read on the report and particularly on the role of Kantian ethics in the report's discussion of autonomy. Beauchamp accuses Baker and McCullough of having too narrow an understanding of the meaning of the term "applied," claiming that no people doing medical ethics today would simply apply ethical theory in a deductivist manner.Finally, Jeremy Sugarman, the physician ethicist, is, in a somewhat surprising turn, the cautious defender of the application that Baker and McCullough challenge. Although he ends up sympathetic with the appropriation that implies going beyond straight-forward top-down application, he outlines the value of ethical theory for the practical analysis of ethical problems in fields such as medicine.ReferenceBaker, Robert, and McCullough, Laurence, eds. 2007. A History of Medical Ethics. New York: Cambridge University Press, in press. [End Page 2]Google ScholarCopyright © 2007 Johns Hopkins University Press... (shrink)

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

The Encyclopedia of Applied Ethics, Second Edition, Four Volume Set addresses both the physiological and the psychological aspects of human behavior. Carefully crafted, well written, and thoroughly indexed, the encyclopedia helps users - whether they are students just beginning formal study of the broad field or specialists in a branch of psychology - understand the field and how and why humans behave as we do. The work is an all-encompassing reference providing a comprehensive and definitive review of the (...) field. A broad and inclusive table of contents ensures detailed investigation of historical and theoretical material as well as in-depth analysis of current issues. Several disciplines may be involved in applied ethics: one branch of applied ethics, for example, bioethics, is commonly explicated in terms of ethical, legal, social, and philosophical issues. Editor-in-Chief Ruth Chadwick has put together a group of leading contributors ranging from philosophers to practitioners in the particular fields in question, to academics from disciplines such as law and economics. The 376 chapters are divided into 4 volumes, each chapter falling into a subject category including Applied Ethics; Bioethics; Computers and Information Management; Economics/Business; Environmental Ethics; Ethics and Politics; Legal; Medical Ethics; Philosophy/Theories; Social; and Social/Media. Concise entries (ten pages on average) provide foundational knowledge of the field Each article will features suggested readings pointing readers to additional sources for more information, a list of related websites, a 5-10 word glossary and a definition paragraph, and cross-references to related articles in the encyclopedia Newly expanded editorial board and a host of international contributors from the US, Australia, Belgium, Canada, France, Germany, Ireland, Israel, Japan, Sweden, and the United Kingdom The 376 chapters are divided into 4 volumes, each chapter falling into a subject category including Applied Ethics; Bioethics; Computers and Information Management; Economics/Business; Environmental Ethics; Ethics and Politics; Legal; Medical Ethics; Philosophy/Theories; Social; and Social/Media. (shrink)

This book treats practical and political reasoning as an active engagement with the world and other people; it cannot be understood as exclusively cognitive and this is seen as a virtue rather than a deficiency. Informal, emotional, characterological, aesthetic and interactional aspects of thought can be constituents of reasonable arguing. The work examines key capacities connected with argumentation, in a variety of fields from professional and medical ethics to work organization and the practice of art.

The recent Covid-19 pandemic has brought a broad range of ethical problems to the forefront, raising fundamental questions about the role of government in response to such outbreaks, the scarcity and allocation of health care resources, the unequal distribution of health risks and economic impacts, and the extent to which individual freedom can be restricted. In this clear introduction to the topic Iwao Hirose explores these ethical questions and analyzes the central issues in the ethics of pandemic response and (...) preparedness such as: The general nature of pandemics and the ethics of preparedness Ethical questions about general goals of pandemic response and preparedness The distribution of scarce resources, e.g., ventilators, hospital beds, antiviral drugs and vaccines Restrictions on individual freedom Ethical questions in the wake of pandemics, including contact-tracing, vaccine passports and socioeconomic inequalities. With the use of real-life examples and a clear philosophical approach, The Ethics of Pandemics is a much-needed introduction to some of the most important ethical issues surrounding pandemics. It is essential reading for students of ethics, bioethics, and political philosophy and will also be of interest to those working in related areas such as public policy, public health, health law, nursing and life sciences. (shrink)

This book addresses the moral, social and political problems emerging from the practice of healing and caring, biomedical research and the provision of health care services. The primary aim of many professional bioethicists is, of late, to solve as efficiently as possible, the problems encountered by health care providers and scientists in clinical, laboratory and administrative settings. Seen from the viewpoint of applied philosophy, however, this is a dangerous tendency if the grounds for the suggested solutions are not properly (...) examined. Even choices which are harmless and seem to involve no immoralities can be indirectly hazardous if those making choices appeal to dubious ethical principles or inaccurate data. This is why this book is dedicated to the examination of the reasons that people can and should have for their health care related decisions as well as to the formulation of good solutions to difficult problems. It covers criterial in life and death decisions, voluntary euthanasia and medical paternalism, wrongful medical authoritarianism, health education, preventive medicine and the welfare of the population, AIDS, discrimination and legal restrictions, and health care policy-making. (shrink)

Vulnerability is an important concern of moral philosophy, political philosophy and many discussions in applied ethics. Yet the concept itself—what it is and why it is morally salient—is under-theorized. _Vulnerability, Autonomy, and Applied Ethics _brings together theorists working on conceptualizing vulnerability as an action-guiding principle in these discussions, as well as bioethicists, medical ethicists and public policy theorists working on instances of vulnerability in specific contexts. This volume offers new and innovative work by Joel Anderson, Carla (...) Bagnoli, Samia Hurst, Catriona Mackenzie and Christine Straehle, who together provide a discussion of the concept of vulnerability from the perspective of individual autonomy. The exchanges among authors will help show the heuristic value of vulnerability that is being developed in the context of liberal political theory and moral philosophy. The book also illustrates how applying the concept of vulnerability to some of the most pressing moral questions in applied ethics can assist us in making moral judgments. This highly innovative and interdisciplinary approach will help those grappling with questions of vulnerability in medical ethics—both theorists and practitioners—by providing principles along which to decide hard cases. (shrink)

This volume presents a number of controversial cases of enforced medical treatment from around the globe, providing for the first time a common, biopolitcal framework for all of them. Bringing together all these real cases guarantees that a new, more complete understanding of the topic will be within grasp for readers unacquainted with the aspects involved in these cases. On the one hand, readers interested mainly in the legal and medical dimensions of cases like those considered will (...) benefit from the explanation of the biopolitical framework within which each case develops. On the other hand, those focusing on only one of the situations presented here will find the parallels between the cases an interesting expansion of the complexity of the problem. Despite the book's ambitious goal, for those willing to use it as supplemental material or interested in only one of the cases, the chapters can function as self-standing pieces to be read separately. This volume will be a valuable tool for both academics and professionals. Bioethicists in both the analytic and continental traditions, will find the book interesting for not only the specific concepts and issues considered, but also for its constructive bridging of the two schools of thought. In addition to philosophers, the structure of this work will also appeal to lawyers, doctors, human rights activists, and anyone concerned in the most disparate way with real-life cases of enforced medical treatment. (shrink)

This book is intended as a practical introduction to the ethical problems which doctors and other health professionals can expect to encounter in their practice. It is divided into three parts: ethical foundations, clinical ethics, and medicine and society. The authors incorporate new chapters on topics such as theories of medical ethics, cultural aspects of medicine, genetic dilemmas, aging, dementia and mortality, research ethics, justice and health care (including an examination of resource allocation), and medicine, (...) ethics and medical law. Medical Ethics also covers issues having to do with the beginning and end of life, as well as ethical questions surrounding the human body and the use of human tissue, confidentiality and AIDS, care of the mentally ill, and the implications of genetic technology. Each chapter presents a range of ethical views, drawing both from traditional philosophy and the most recent contemporary trends. The theoretical discussion is extended and illustrated by case studies and examples. This book is a non-technical guide to ethics written with the needs of medical students and medical practitioners in mind. It will also appeal to students and practitioners of allied health professions, and for all users of health care services. (shrink)

The COVID-19 pandemic in 2020 has had a lasting impact on all areas of personal life. However, the political, economic, legal and healthcare system, as well as the education system have also experienced the effects. Universities had to face new challenges and requirements in teaching and examinations as quickly as possible in order to be able to guarantee high-quality education for their students.This study aims to examine how the German-speaking medical faculties of the Umbrella Consortium of Assessment Network (...) have dealt with the challenges but also the opportunities that the outbreak of the COVID-19 pandemic created in medical education and whether digitalisation has been driven forward as a result. In an initial online-survey we focused our questions on the current teaching situation with regard to digitised teaching content, the support or establishment of adequate framework conditions by the medical faculties and IT facilities and also the execution of examinations during the summer semester 2020.Between August and September 2020, a total of 88 examiners, educators, dean of study and/or technical admins from 32 partner faculties took part in the survey. Students were not included in our survey. Most respondents stated that a switch to a digital semester had worked, the use of e-learning increased compared to previous semesters and that most courses could be converted, with the exception of practical courses, which were largely cancelled. The respondents also indicated that most examinations could still be taken, with the exception of practical examination formats, like Objective Structured Clinical Examinations. However, in the case of face-to-face examinations, strict distance and hygiene conditions had to be obeyed or there had to be a switch to distance-online examinations, which raised many open issues such as equal opportunities of students and attempts at deception.In conclusion, we identified several issues regarding the rapid transition to a digital semester due to COVID-19 which were categorised into the following topics: Face-to-face teaching could not take place, know-how of educators, integrity aspects, technical aspects, additional personnel required, additional time and effort required for implementation of digital teaching. Our study shows that a switch to digital teaching and distance online examinations is feasible, but many problems were encountered concerning academic integrity and basic ethical principles still need to be solved. In order to investigate whether above mentioned issued could be solved one year after the transition to a digital semester, we conducted a second survey in which the 32 initially surveyed institutions were questioned again. (shrink)

In 2014, the first child in the world was born after live uterus transplantation and IVF (UTx-IVF). Before and after this event, ethical aspects of UTx-IVF have been discussed in the medical and bioethical debate as well as, with varying intensity, in Swedish media and political fora. This article examines what comes to be identified as important ethical problems and solutions in the media debate of UTx-IVF in Sweden, showing specifically how problems, target groups, goals, benefits, risks (...) and stakes are delineated and positioned. It also demonstrates how specific assumptions, norms and values are expressed and used to underpin specific positions within this debate, and how certain subjects, desires and risks become shrouded or simply omitted from it. This approach—which we label the Ethics of the Societal Entrenchment-approach, inspired by Koch and Stemerding (1994)—allows us to discuss how the identification of something as the problem helps to shape what gets to be described as a solution, and how specific solutions provide frameworks within which problems can be stated and emphasised. We also offer a critical discussion of whether some of these articulations and formations should be seen as ethically troubling, and if so, why. (shrink)

Meaningful participant engagement has been identified as a key contributor to the success of efforts to share data via a “Medical Information Commons”. We present findings from expert stakeholder interviews aimed at understanding barriers to engagement and the appropriate role of MIC participants. Although most interviewees supported engagement, they distinguished between individual versus collective forms. They also noted challenges including representation and perceived inefficiency, prompting reflection on political aspects of engagement and efficiency concerns.

While the importance of Consent has been discussed widely over the last few decades, interest in its study has received renewed attention in recent years, particularly regarding medical treatment, clinical research and sexual acts. The Routledge Handbook of the Ethics of Consent is an outstanding reference source to this exciting subject and the first collection of its kind. Comprising over thirty chapters by a team of international contributors the Handbook is divided into five main parts: General Questions Normative (...) Ethics Legal Theory Medical Ethics Political Philosophy ¿ Within these sections central issues, debates and problems are examined, including: the nature and normative importance of consent, paternalism, exploitation and coercion, privacy, sexual consent, consent and criminal law, informed consent, organ donation, clinical research, and consent theory of political obligation and authority. ¿ The Routledge Handbook of the Ethics of Consent is essential reading for students and researchers in moral theory, applied ethics, medical ethics, philosophy of law and political philosophy. This volume will also be very useful for those in related fields, such as political science, law, medicine and social science. (shrink)

The issues of medical ethics, from moral quandaries of euthanasia and the morality of killing to political dilemmas like fair healthcare distribution, are rarely out of today's media. This area of ethics covers a wide range of issues, from mental health to reproductive medicine, as well as including management issues such as resource allocation, and has proven to hold enduring interest for the general public as well as the medical practitioner. This Very Short Introduction provides (...) an invaluable tool with which to think about the ethical values that lie at the heart of medicine. This new edition explores the ethical reasoning we can use to approach medical ethics, introducing the most important 'tools' of ethical reasoning, and discussing how argument, thought experiments, and intuition can be combined in the consideration of medical ethics. Considering its practical application, Tony Hope and Michael Dunn explore how medical ethics supports health professionals through the growing use of ethics expertise in clinical settings. They also contemplate the increasingly important place of medical ethics in the wider social context, particularly in this age of globalization, not only in healthcare practice, but also policy, discussions in the media, pressure group and activism settings, and in legal judgments. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable. (shrink)

Bioethics claimed to offer a set of generally applicable, universally accepted guidelines that would simplify complex situations. In Thieves of Virtue, Tom Koch argues that bioethics has failed to deliver on its promises.

Available from UMI in association with The British Library. ;Typically we maintain two incompatible standards towards right action and good character, and the tension between these polarities creates the paradox of moral luck. In practice we regard actions as right or wrong, and character as good or bad, partly according to what happens as a result of the agent's decision. Yet we also think that people should not be held responsible for matters beyond their control. ;This split underpins Kant's assertion (...) that only the good will is securely good, that its goodness is impervious to outcome ill-luck. Some commentators, such as Martha Nussbaum and to some extent Bernard Williams, think that this simply writes off the paradox. Williams asserts that the paradox is insoluble, and that its inescapability threatens the notion of agent responsibility. In contrast Thomas Nagel argues that agents' most cherished projects may be indeed be subject to luck, but that does not mean that their deepest motivations are moral. This, I suggest, is one of several means whereby we might limit the effect of the paradox without denying that the tension exists. But I also argue that it is wrong to accuse Kant of ignoring the paradox. ;Ethical consequentialists, on the other hand, appear to have no problem with moral luck, because the paradox depends on a dichotomy between the outside world and the locus of moral worth in the individual agent. But this turns out not to be true. The problem of moral luck is not some strange Kantian fixation, but a general dilemma: a variant on what Nagel terms "the problem of excess objectivity" which cuts across all of ethics and metaphysics. ;Retaining a broadly Kantian notion of agent-responsibility, but limiting what agents are responsible for, requires us to delineate the realm of ethics more narrowly than has been done by those who believe that the rational and/or prudential are coterminous with the ethical. This strategy for minimising the paradox's impact is explored in two areas from medical ethics, the allocation of scarce medical resources and informed consent, and two from public policy, secrecy and nuclear deterrence. Throughout, the analysis seeks to test Nagel's maxim that the best we can hope for is to act in such a manner that we would not have to revise our opinion of how we should have acted once the consequences of our actions become apparent. (shrink)

Authoritarian governments are characterised by political systems with concentrated and centralised power. Healthcare is a critical component of any state. Given the powers of an authoritarian regime, we consider the opportunities they possess to derive good health outcomes. The 2019 Varsity Medical Ethics Debate convened on the motion: ‘This house believes authoritarian government is the route to good health outcomes’ with Oxford as the Proposition and Cambridge as the Opposition. This article summarises and extends key arguments made (...) during the 11th annual debate between medical students from the Universities of Oxford and Cambridge. By contrasting the principles underlying authoritarianism and democracy, it enables a discussion into how they translate into healthcare provision and the outcomes derived. Based on the foundation of said principles, an exploration of select cases represents examples of applications and the results. We analyse the past, present and future implications on the basis of fundamental patient-centred care. (shrink)

In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent their child. (...) class='Hi'>Ethics of service provision or services planning (e.g. Culyer, 2001; McLachlan, 2005; see also Newbigging and Paul, chapter xxx), or the provision of other services (e.g. education, child protection) although intensely relevant to this area are not addressed in this chapter nor will we deal with the complex aspects of medical ethics relating to the treatment of children (Baines, 2008). We use the term ‘parent’ to refer to any adult person who fulfils a substantive parental role with a child. Defining what counts as a family will in certain circumstances be contentious. There are diverse patterns of family arrangements that may be influenced by cultural, political economic and temporal factors. For the purposes of our discussion, we define a family in terms of its role in childrearing, as a group of at least one adult and at least one child, living together in long term relationships on an ongoing basis with vested interest in the well being of each of the family members. (shrink)

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. (shrink)

Medicalization occurs when an aspect of embodied humanity is scrutinized by the medical industry, claimed as pathological, and subsumed under medical intervention. Numerous critiques of medicalization appear in academic literature, often put forth by bioethicists who use a variety of “lenses” to make their case. Feminist critiques of medicalization raise the concerns of the politically disenfranchised, thus seeking to protect women—particularly natal sex women—from medical exploitation. This article will focus on three feminist critiques of medicalization, which offer (...) an alternative narrative of sickness and health. I will first briefly describe the philosophical origins of medicalization. Then, I will present three feminist critiques of medicalization. Liberal feminism, trans feminism, and crip feminism tend to regard Western medicine with a hermeneutics of suspicion and draw out potential harms of medicalization of reproductive sexuality, gender, and disability, respectively. While neither these branches of feminism—nor their critiques—are homogenous, they provide much-needed commentaries on phallocentric medicine. I will conclude the paper by arguing for the continual need for feminist critiques of medicalization, using uterus transplantation as a relevant case study. (shrink)

How care can resist the stifling force of the neoliberal paradigm In a world brimming with tremendous wealth and resources, too many are suffering the oppression of precarious existences--and with no adequate relief from free market-driven institutions. Care Ethics in the Age of Precarity assembles an international group of interdisciplinary scholars to explore the question of care theory as a response to market-driven capitalism, addressing the relationship of three of the most compelling social and political subjects today: care, (...) precarity, and neoliberalism. While care theory often centers on questions of individual actions and choices, this collection instead connects theory to the contemporary political moment and public sphere. The contributors address the link between neoliberal values--such as individualism, productive exchange, and the free market--and the pervasive state of precarity and vulnerability in which so many find themselves. From disability studies and medical ethics to natural-disaster responses and the posthuman, examples from Māori, Dutch, and Japanese politics to the COVID-19 pandemic and the Black Lives Matter movement, this collection presents illuminating new ways of considering precarity in our world. Care Ethics in the Age of Precarity offers a hopeful tone in the growing valorization of care, demonstrating the need for an innovative approach to precarity within entrenched systems of oppression and a change in priorities around the basic needs of humanity. Contributors: Andries Baart, U Medical Center Utrecht, Tilburg U, and Catholic Theological U Utrecht, the Netherlands; Vrinda Dalmiya, U of Hawaii, Mānoa; Emilie Dionne, U Laval; Maggie FitzGerald, U of Saskatchewan; Sacha Ghandeharian, Carleton U; Eva Feder Kittay, Stony Brook U/SUNY; Carlo Leget, U of Humanistic Studies in Utrecht, the Netherlands; Sarah Clark Miller, Penn State U; Luigina Mortari, U of Verona; Yayo Okano, Doshisha U, Kyoto, Japan; Elena Pulcini, U of Florence. (shrink)

Unethical practices in education come at too great a cost when our future generation is at stake. Educators are role models for students in their future careers and so must believe in and use ethical practices. In politics, in big and small business, and in legal and medical practice the question of ethical practices surrounds us. Have people become desensitized to ethics? Are we condoning unethical practice? Our educational profession must stand up for honesty and integrity. We, as (...) educators, have the obligation of setting the standards for ethics. Ethical Dilemmas in Education addresses the dilemmas teachers face every day throughout all aspects of education in a comprehensive manner. The book outlines standards of professionalism and presents information teachers can use for the challenges teachers face. With the policies of today's educational system, teachers need to stand up for honesty and integrity, providing role models for students in their future careers. This book guides teachers towards developing ethical habits and a professional demeanor. (shrink)

Over the last four decades, Vilhjálmur Árnason professor emeritus in philosophy, has been at the forefront in the academic fields of moral and political philosophy, and medical – and bioethics in Iceland. His research and in-depth understanding of the ethical aspects of medicine and life sciences in Icelandic society are demonstrated by his extensive written work on these issues. In 1993, the first edition of his book _Ethics of life and death_ was published in Iceland, a comprehensive (...) book on ethical issues related to healthcare, research, and public health. A second and improved edition of the book was published in 2003, and a German version in 2004. The third and latest edition was published in August 2023, which takes into account developments in the aforementioned fields in recent years, and as before with a particular focus on Iceland. The contents of this influential book will be discussed in this article, with special emphasis on comparing current subjects with previous editions. Moreover, it will be addressed if and how Árnason‘s thinking and perspective have changed over the years. (shrink)

The author of this comment suggests that some of the important points made by Dr Adrian Rogers are vitiated by a tendency to contrast the worst of modern medical practice with an over-idealised view of the past. The state of medical ethics today, the author suggests, is more hopeful than Dr Rogers allows.

The work related to medical ethics written by Polish authors are reviewed and some topics concerning teaching and various other activities in this field are presented. The attention is centered on the opinions and attitudes concerning the essence of medical profession and the personal model of the physician, doctor-patient relationship (including duties of the doctor), medical research on humans, abortion and other problems. The role of medico-ethical tradition in Poland is described. Main trends in polish ethical (...) thought in relation to medicine are taken into consideration. General aspects of medical ethics in present-day Poland are tentatively characterized. (shrink)