Theological basis -- Religion and health care -- The dignity of human life -- The integrity of the human person -- Implications for health care -- Theological principles in health care ethics -- Method -- The levels and questions of ethics -- Freedom and the moral agent -- Right and wrong -- Metaethics -- Method in Catholic bioethics -- Catholic method and birth control -- The principle of double effect -- Application -- Forgoing treatment, pillar one: (...) ordinary and extraordinary means -- Forgoing treatment, pillar two: killing and allowing to die -- Forgoing treatment, pillar three: decisions by competent patients -- Forgoing treatment, pillar three: decisions for incompetent patients -- Forgoing treatment, pillar three: advance directives -- Hydration and nutrition -- Physician-assisted suicide and euthanasia -- Medical futility -- Pain and pain management -- Ethics committees -- Embryonic stem cells and the beginning of human personhood -- Genetic engineering -- Allocating health care resources -- The use and misuse of the allocation argument. (shrink)
Machine generated contents note: Abbreviations; Preface; Introduction; Part I. How are we to do Bioethics?: Section 1. Context: Challenges and Resources of a New Millennium: 1. Sex and life in post-modernity; 2. Catholic engagement with the culture of modernity; 3. Promising developments; 4. Conclusion; Section 2. Conscience: The Crisis of Authority: 5. The voice of conscience; 6. The voice of the magisterium; 7. Conscience in post-modernity; 8. Where to from here?; Section 3. Cooperation: Should we ever Collaborate with Wrongdoing?: (...) 9. Traditional example; 10. Five modern examples; 11. Some fundamental issues raised by these examples; 12. Why it matters so much; 13. Conclusion; Part II. Beginning-of-Life: Section 4. Beginnings: When do People Begin?: 14. Method, thesis and implications; 15. A closer look at Ford's science; 16. A closer look at Ford's philosophy; 17. Individuality criteria; 18. Conclusions; Section 5. Stem Cells: What's all the Fuss About?: 19. Scientific potential and concerns about stem cells; 20. Ethical concerns about embryonic stem cells; 21. Social concerns about embryonic stem cells; Section 6. Abortion - and the New Eugenics: 22. The perennial debate about abortion; 23. Pre-natal screening: a search and destroy mission?; 24. The new abortion debate; Part III. Later Life: Section 7. Transplants: Bodies, Relationships and Ethics: 25. Love beyond death; 26. Conceptions of the body and relationships in organ transplantation; 27. Fashionable bioethical approaches to organ procurement; 28. Better bioethical approaches to organ procurement; 29. Ethical issues in organ reception; 30. Conclusion; Section 8. Artificial Nutrition: Why do Unresponsive Patients Matter?: 31. Civilisation after Schiavo?; 32. Why the unresponsive still matter: a philosophical account; 33. Why the unresponsive still matter: a theological account; 34. Some final questions; Section 9. Endings: Suicide and Euthanasia in the Bible: 35. The problem of suicide and euthanasia in the Bible; 36. Suicides and euthanasias in the Bible; 37. The Scriptural basis of Judeo-Christian opposition to suicide and euthanasia; Part IV. Protecting Life: Section 10. Identity: What Role for a Catholic Hospital?: 38. A tale of two hospitals; 39. Current challenges for Catholic hospitals; 40. Catholic hospitals as diakonia; 41. Catholic hospitals as martyria; 42. Catholic hospitals as leitourgia; 43. Conclusion: six tasks for a new century; Section 11. Regulation: What Kinds of Laws and Social Policies?: 44. A tale of three politicians; 45. Catholic principles for politicians; 46. Reasonable stances for a pro-life politician; 47. Some virtues of a pro-life politician. (shrink)
This paper is an analysis of the relationship of social ethics and bioethics in Roman Catholic theology. The argument of the paper is that the character of both Catholic moral theology and ecclesiology shape the broadly defined interest of the church in bioethics. The paper examines the common elements of social ethics and bioethics in Catholic teaching, describes how ecclesiology shapes Catholic public policy and uses the examples of abortion and health care to (...) illustrate the relationship of Catholic social thought and bioethics. In developing the relationship of these two dimensions of Catholic moral argument the article highlights how the appeal to natural law categories differs in social ethics and bioethics and how the two topics are received differently in the theological community. It also seeks to illustrate how the premises of Catholic social ethics remain central to public positions taken on bioethics. Keywords: ecclesiology, moral theology, natural law, social ethics CiteULike Connotea Del.icio.us What's this? (shrink)
Introduction -- Overview of the contemporary global context : life stories -- Data on poverty, hunger, and inequality in an age of globalization -- The goals and structure of this book -- Development theory and practice : an overview -- Origins of the concept of development -- Modernization theory -- Modernization theory and U.S. aid policy -- The impact of modernizationist development -- Structuralist economic theories -- Dependency theories -- Basic needs approach -- New international economic order -- Alternative development (...) -- The impact of reformist thought on development policy -- Neoliberal resurgence and structural adjustment policies -- Current debates in development studies -- The failures of modernizationist development : a closer look -- The impacts of colonialism and slavery -- Post-WW II development policies and the third world debt crisis -- Consequences of debt and structural adjustment -- Responses to the debt crisis -- United States opposition to social change in the third world -- Summary of major structural influences on the third world -- Catholic social teaching and development -- CST prior to Pope John XXIII -- Early reflections on development : John XXIII and Vatican II -- The pivotal contributions of Paul VI, the Latin American bishops, and justice in the world -- John Paul II : the centrality of solidarity -- The social ethics of Benedict XVI -- Summary of catholic social teaching on development issues -- Catholic social teaching and political economy : neoconservative and radical critiques -- Neoconservative reflections on CST -- Radical reflections on CST -- Evaluation of neoconservative, radical, and CST views -- Grassroots critics of development and neoliberal globalization -- Rejecting the quest for development - Vandana shiva : the violence of development and reductionist science -- Further issues in the development/globalization debates -- Reclaiming the commons : the positive visions of development critics -- Catholic social teaching, the radical tradition, and development critics -- Grassroots action and policy alternatives -- Grassroots organizations in the third world : an overview -- The impact of grassroots organizations -- Development policies : follow the nic model -- Alternative development policies -- Differing visions : alternative development vs. regeneration -- Prospects for the adoption of alternative policies -- Re-envisioning C atholic social teaching -- The contributions of CST to the development debate -- Enhancing Catholic social teaching -- Structural analysis of capitalism -- Women, development, and CST -- CST, modernization, and cultural diversity -- CST and ecology - CST, grassroots movements, and social struggle -- The church and social change -- Social criticism and pioneering creativity : how Christians can constructively address issues of development and globalization -- Education -- Lifestyle choices -- Responsible purchasing -- Responsible investment -- Organizing, activism, and aid provision -- Direct service/solidarity -- Responsible parenting -- Applying CST in the life of the church -- Concluding reflections -- Theological epilogue: The path of discipleship. (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 medicalethics 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 medicalethics 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)
A physician says, "I have an ethical obligation never to cause the death of a patient," another responds, "My ethical obligation is to relieve pain even if the patient dies." The current argument over the role of physicians in assisting patients to die constantly refers to the ethical duties of the profession. References to the Hippocratic Oath are often heard. Many modern problems, from assisted suicide to accessible health care, raise questions about the traditional ethics of medicine and the (...)medical profession. However, few know what the traditional ethics are and how they came into being. This book provides a brief tour of the complex story of medicalethics evolved over centuries in both Western and Eastern culture. It sets this story in the social and cultural contexts in which the work of healing was practiced and suggests that, behind the many different perceptions about the ethical duties of physicians, certain themes appear constantly, and may be relevant to modern debates. The book begins with the Hippocratic medicine of ancient Greece, moves through the Middle Ages, Renaissance and Enlightenment in Europe, and the long history of Indian and Chinese medicine, ending as the problems raised modern medical science and technology challenge the settled ethics of the long tradition. (shrink)
Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's religious beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of MedicalEthics offers a real-life view of the central issue involved in clinical medicalethics. Since (...) the analysis of cases plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medicalethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of MedicalEthics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions. (shrink)
This collection brings together original essays demonstrating the cutting edge of philosophical research in medicalethics. With contributions from a range of established and up-and-coming authors, it examines topics at the forefront of medical technology, such as ethical issues raised by developments in how we research stem cells and genetic engineering, as well as new questions raised by methodological changes in how we approach medicalethics.
The Cambridge World History of MedicalEthics is the first comprehensive scholarly account of the global history of medicalethics. Offering original interpretations of the field by leading bioethicists and historians of medicine, it will serve as the essential point of departure for future scholarship in the field. The volumes reconceptualize the history of medicalethics through the creation of new categories, including the life cycle; discourses of religion, philosophy, and bioethics; and the relationship (...) between medicalethics and the state, which includes a historical reexamination of the ethics of apartheid, colonialism, communism, health policy, imperialism, militarism, Nazi medicine, Nazi "medicalethics," and research ethics. Also included are the first global chronology of persons and texts; the first concise biographies of major figures in medicalethics; and the first comprehensive bibliography of the history of medicalethics. An extensive index guides readers to topics, texts, and proper names. (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 medicalethics, cultural aspects of medicine, genetic dilemmas, aging, dementia and mortality, research ethics, justice and health care (including an examination of resource allocation), and medicine, (...) class='Hi'>ethics and medical law. MedicalEthics 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 practice of clinical medicine is inextricably linked with the need for moral values and ethical principles. The study of medicalethics is, therefore, rightly assuming an increasingly significant place in undergraduate and postgraduate medical courses and in allied health curricula. Making Sense of MedicalEthics offers a no-nonsense introduction to the principles of medicalethics, as applied to the everyday care of patients, the development of novel therapies and the undertaking of pioneering (...) basic medical research. Written from a practical rather than a philosophical perspective, the authors call upon their extensive experience of clinical practice, research and teaching to illustrate how ethical principles can be applied in different "real-life" situations. Making Sense of MedicalEthics encourages readers to understand the principles of medicalethics as they apply to clinical practice; explore and evaluate common misconceptions; consider the ethics underlying any medical decision; and as a result, to realize that a good appreciation of medicalethics will help them to practice more effectively in the future. (shrink)
How is the concept of patient care adapting in response to rapid changes in healthcare delivery and advances in medical technology? How are questions of ethical responsibility and social diversity shaping the definitions of healthcare? In this topical study, scholars in anthropology, nursing theory, law and ethics explore questions involving the changing relationship between patient care and medicalethics. Contributors address issues that challenge the boundaries of patient care, such as: · HIV-related care and research · (...) the impact of new reproductive technologies · preventative healthcare · technological breakthroughs that are changing personal-caring relationships. Chapters range from a consideration of the practicalities of nursing and family healthcare to a debate about ‘universal human needs’ and patients’ rights. This book is a provocative exploration of the ways in which healthcare models are socially constructed. It will be of interest to policy-makers, medical practitioners and administrators, as well as students of sociology, anthropology and social policy. (shrink)
This interactive independent teaching and learning tutorial can be used by individuals or small groups and takes a problem-based-learning approach to the complex legal and ethical issues raised by six scenarios. Based on real cases clearly demonstrating the problems arising from recent medical advancements, the cases cover reproductive technology, consent, genetic screening, participation in research trials, paternity and confidentiality. Additional features of the CD-ROM are a comprehensive glossary, cross-references to The Cambridge MedicalEthics Workbook and definitions from (...) the Dictionary of MedicalEthics. (shrink)
Disciplining doctors : medical courts of honour and professional conduct -- Medical confidentiality : the debate on private versus public interests -- Patient information and consent : self-determination versus paternalism -- Duties and habitus of a doctor : the literature on medicalethics.
This new edition of Law and MedicalEthics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.
Introduction -- Historical perspectives of medicalethics -- The medicalethics Renaissance: a brief assessment -- Risk disclosure/'informed consent' -- Consent, control and minors: Gillick and beyond -- Sterilisation/best interests: legislation intervenes -- The end of life: total abrogation -- Medicalethics in government-commissioned reports -- Conclusion.
Thus far in the development of the discipline of medicalethics, the overriding concern has been with solutions to specific problems. But discussion is hampered by lack of understanding of the scope and methodology of medicalethics, and its scientific and philosophical basis. In Underpinnings of MedicalEthics Edmond A. Murphy, James J. Butzow, and Edward L. Suarez-Murias offer much-needed clarification of the purview, ontological basis, and methodology of a medicalethics that (...) is to be comprehensive and yet readily accepted by all. The authors begin by describing the scope of the analysis and discussing possible ethical systems and paradigms. They then deal with the structures and concepts necessary in the formulation of a coherent philosophy: normality and disease, scientific and juridical law, certainty and certitude, decisions. Finally, they introduce particular human dimensions, such as quality of life, pain, and responsibility. Throughout, case examples illustrate the authors' theoretical framework. (shrink)
This rich collection, popular among teachers and students alike, provides an in-depth look at major cases that have shaped the field of medicalethics. The book presents each famous (or infamous) case using extensive historical and contextual background, and then proceeds to illuminate it by careful discussion of pertinent philosophical theories and legal and ethical issues.
The Blackwell Guide to MedicalEthics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, (...) resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy. (shrink)
Medicalethics changed dramatically in the past 30 years because physicians and humanists actively engaged each other in discussions that sometimes led to confrontation and controversy, but usually have improved the quality of medical decision-making. Before then medicalethics had been isolated for almost two centuries from the larger philosophical, social, and religious controversies of the time. There was, however, an earlier period where leaders in medicine and in the humanities worked closely together and both (...) fields were richer for it. This volume begins with the 18th century Scottish Enlightenment when professors of medicine such as John Gregory, Edward Percival, and the American, Benjamin Rush, were close friends of philosophers like David Hume, Adam Smith, and Thomas Reid. They continually exchanged views on matters of ethics with each other in print, at meetings of elite intellectual groups, and at the dinner table. Then something happened, physicians and humanists quit talking with each other. In searching for the causes of the collapse, this book identifies shifts in the social class of physicians, developments in medical science, and changes in the patterns of medical education. Only in the past three decades has the dialogue resumed as physicians turned to humanists for help just when humanists wanted their work to be relevant to real-life social problems. Again, the book asks why, finding answers in the shift from acute to chronic disease as the dominant pattern of illness, the social rights revolution of the 1960's, and the increasing dissonance between physician ethics and ethics outside medicine. The book tells the critical story of how the breakdown in communication between physicians and humanists occurred and how it was repaired when new developments in medicine together with a social revolution forced the leaders of these two fields to resume their dialogue. (shrink)
Machine generated contents note: Introduction Chapter 1: The basics of ethical decision-making Chapter 2: Hospital ethics committees and clinical ethicists Chapter 3: The settings of health care ethical dilemmas Chapter 4: Advance directives Chapter 5: Do Not Resuscitate orders and "Code Blue" Chapter 6: Non-beneficial medical interventions Chapter 7: Quality of life and treatment burdens Chapter 8: Patient privacy and confidentiality Chapter 9: Refusing medical treatment Chapter 10: Health care at the end of life Chapter 11: Transplant (...)ethics Chapter 12: Neuroethics Chapter 13: Ethics and reproductive technology Chapter 14: Genetics and ethics Chapter 15: Pediatric ethics Chapter 16: Participating in a research study Appendix A: Resource List Appendix B: Glossary Index. (shrink)
This is a practical introduction to the range of ethical questions which doctors and other health-care professionals may be expected to encounter in practice. The books covers both the traditional "end of life" issues and also deals with medical research and consent issues, confidentiality and AIDS, resource allocation, care of the mentally ill, and the doctor/patient relationship. Each chapter canvasses a range of ethical views, drawing both from traditional philosophical responses and the most recent contemporary responses. Theoretical discussion is (...) extended and enlivened by the use of hypothetical and actual examples, suitable both for private study or group discussion. While the needs of medical students for a non-technical guide to ethics have been kept firmly in mind, the clarity of writing and avoidance of specialist medical and philosophical terminology ensure that it will be of value to students of nursing and related disciplines, and accessible to the lay reader. (shrink)
Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.
United States military medicalethics evolved during its involvement in two recent wars, Gulf War I (1990–1991) and the War on Terror (2001–). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a ‘new kind of war’. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of (...) trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medicalethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medicalethics are not established. Looking to the future, medicine and medicalethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medicalethics do not evolve simply in accord with military exigency. (shrink)
Foundations of medicalethics and law -- Professionalism and medicalethics -- The doctor, the patient, and society -- Ethics and law at the beginning and end of life -- Healthcare commissioning and resource allocation -- Introduction to sociology and disease -- Experience of health and illness -- Organization of health care provision in the UK -- Inequalities in health and health care provision -- Epidemiology and public health -- Clinical governance.
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)
Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, (...) traditions, and models. In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers. (shrink)
Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second- and third-year one-semester ethics courses offered in medical schools, health sciences departments, and nursing programs. By taking an applied approach rather than a theoretical approach, this text serves the needs of medical and nursing students, residents, and practicing physicians by sorting through questions of moral principles relevant (...) to the diverse and growing number of healthcare professionals. The many topics covered include truth telling, refusal of treatment, assisted suicide, managing error, and reproductive choice. (shrink)
In The Body of Compassion, Joel Shuman presents an important, new theological treatment of contemporary bioethics, weaving together personal experience, a critical treatise on contemporary bioethics, and an exploration of a Christian theological alternative.The author first draws the reader into a consideration of the current state of bioethics by relating the story of his grandfather, a hard-working family man who died a solitary death, unaccompanied by loved ones, in the unfamiliar and sterile world of a hospital. Troubled by the way (...) his grandfather died, Shuman takes the reader along as he explores how modern medicine has distanced itself from dealing with people as living beings beyond their immediate physicality. He examines how various approaches to bioethics over the past twenty years have tried to remedy this problem by prescribing certain standards for treatment and how each of these ultimately has fallen short due to the lack of “a teleological concern for the body”—i.e., to trying to understand what the body is actually for in a larger context. From this point, Shuman deftly moves to a discussion of the centrality of the body to Christianity, focusing on how baptism, participation in the liturgy, and the partaking of the Eucharist all serve to unite Christians as one in the body of Christ. For Christians, the author argues, the body does not just belong to the individual but rather is one with the community of the Church. With this in mind, Shuman proposes a new kind of bioethics for Christians, where care for the body of Christ becomes the model of how we should care for and receive care from each other.This fresh and thought-provoking book is sure to be of interest to ethicists, medical professionals, and everyone who is troubled by places where science and religion intersect and seem to conflict. (shrink)
Tough Decisions presents many of the complex medical-ethical issues likely to confront practitioners in critical situations. Through fictional but true-to-life cases, vividly described in clinical terms, the authors force the reader to choose among different courses of action and to confront a range of possible consequences. A two-year-old has been diagnosed with a malignant brain tumor. Who should be allowed to make decisions about the child's surgery and subsequent therapy, and on what basis? A family history of Huntington's disease (...) emerges when a fiancee seeks genetic counseling. Who should be informed? An elderly patient suffers a cardiac arrest. Should "do-not-resuscitate" orders always be followed? How should legal liability affect medical decisions? Other ethical issues considered include surgical complications, patient autonomy, rights of the retarded, informed consent, euthanasia, and the fair allocation of finite resources. Each case presented conveys the drama and pressure of weighing alternatives, and the realistic consequences of the choices made. The authors show that ethical decision-making is not limited to "matters of life and death", and that it is not the decision but the ethical process by which it is made that gives the decision moral integrity. With realistic detail, Tough Decisions brings to life and makes the student share in the many complexities of ethical decision-making when the health and lives of patients are at stake. (shrink)
This is a comprehensive and practical guide to the ethical issues raised by different kinds of medical research, and is the first such book to be written with the needs of the researcher in mind. Clearly structured and written in a plain and accessible style, the book covers every significant ethical issue likely to be faced by researchers and research ethics committees. The author outlines and clarifies official guidelines, gives practical advice on how to adhere to these, and (...) suggests procedures in areas where official recommendations are vague or absent. This invaluable handbook will help researchers identify and address the ethical issues at an early stage in the design of their studies, to avoid unnecessary delay and to safeguard the wellbeing of patients and healthy volunteers. It will also be extremely useful to members of research ethics committees. (shrink)
We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education—first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and third, (...) avoiding temptations to dismiss moral distress as a mere “hidden curriculum” problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness. (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)
The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.
The release of the Vatican instruction on homosexuality in the priesthood and Catholic seminaries poses several challenging ethical issues for the psychologists who conduct psychological screening evaluations for those men interested in religious life as Catholic priests. This brief article reviews some of the key ethical issues associated with these evaluations in light of the new Vatican instruction on homosexuality. The RRICC model based on the American Psychological Association's Code of Ethics (i.e., responsibility, respect, integrity, competence, and (...) concern) is used to highlight some of the ethical challenges for psychologist evaluators. (shrink)
Mainstream philosophical discussions of ethics usually involve either a search for a problem-solving theory (such as utilitarianism), or an exploration of ontological status (of things like obligations or reasons). This book will argue that such efforts are often misplaced. Instead, the proper starting point should always be the actual words and deeds of ordinary people in ordinary disagreements; for the ethical concepts in play can only derive their full meaning within the context of ordinary human lives. This will require (...) a better understanding of the 'ordinary', and of what it means to lead a life. (shrink)
Providing health care in the most cost-effective way has become a priority in recent years. This book tackles the important issue of the potential conflict between economic expediency and the welfare of individual patients. Contributors examine different attitudes to this complex problem, along with a variety of legal and historical perspectives. The book addresses particular aspects of health care, such as medical expert systems, general practice, medical education, and clinical decision-making where the direct involvement of doctors in allocating (...) scarce and expensive resources is perhaps most obvious. (shrink)
The CatholicChurch proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by (...) such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance. (shrink)
Roman Catholics have a long tradition of evaluating medical treatment at the end of life to determine if proposed interventions are proportionate and morally obligatory or disproportionate and morally optional. There has been significant debate within the Catholic community about whether artificially delivered nutrition and hydration can be appreciated as a medical intervention that may be optional in some situations, or if it should be treated as essentially obligatory in all circumstances. Recent statements from the teaching authority (...) of the church have attempted to clarify this issue, especially for those with a condition known as the persistent vegetative state. I argue that these recent teachings constitute a “general norm” whereby artificial nutrition and hydration are considered obligatory for most patients, but that these documents allow for exception in cases of complication from the means used to deliver nutrition and hydration, progressive illness, or clear refusal of such treatment by patients. While the recent clarifications do not constitute a major deviation from traditional understanding and will rarely conflict with advance directives or legal statutes, there may be rare instances in which remaining faithful to church teaching may conflict with legally enshrined patient prerogatives. Using the Texas Advance Directives Act as an example, I propose ways in which ethics committees can remain faithful to their Roman Catholic identity while respecting patient autonomy and state law pertaining to end of life health care. (shrink)
This book provides a clear, concise description of medical law; but it does more than that. It also provides an introduction to the ethical principles that can be used to challenge or support the law. It also provides a range of perspectives from which to analyse the law: feminist, religious and sociological perspectives are all used.
In recent decades, the revival of natural law theory in modern moral philosophy has been an exciting and important development. Human Values brings together an international group of moral philosophers who in various respects share the aims and ideals of natural law ethics. In their diverse ways, these authors make distinctive and original contributions to the continuing project of developing natural law ethics as a comprehensive treatment of modern ethical theory and practice.
The mystery of Aquinas's virtue ethics -- The gifts as second-personal dispositions -- Virtues and the second-person perspective -- The fruition of the virtues and gifts -- Conclusions and implications.
Does the position of the Roman CatholicChurch on contraception also imply that the usage of condoms by HIV-discordant couples is illicit? A standard argument is to appeal to the doctrine of double effect to condone such usage, but this meets with the objection that there exists an alternative action that brings about the good effect—namely, abstinence. I argue against this objection, because an HIV-discordant couple does not bring about any bad outcome through condom usage—there is no disrespect (...) displayed for the generative function of sex. One might retort that the badness of condom usage consists in thwarting the unitive function of sex. I argue that also this objection cannot be upheld. In conclusion, if there are no in-principle objections against condom usage for HIV-discordant couples, then policies that deny access to condoms to such couples are indefensible. HIV-discordant couples have a right to continue consummating their marriage in a manner that is minimally risky and this right cannot be trumped by utilitarian concerns that the distribution of condoms might increase promiscuity and along with it the HIV infection rate. (shrink)