It might seem that racial profiling by doctors raised few of the same concerns as racial profiling by police, immigration, or airport security. This paper argues that the similarities are greater than first appear. The inappropriate use of racial generalizations by doctors may be as harmful and insulting as their use by law enforcement officials. Indeed, the former may be more problematic in compromising an ideal of individualized treatment that is more applicable to doctors than to police. Yet doctors, unlike (...) police, should not attempt to ignore race altogether. Race and ethnicity are associated with the geography of disease, with social and cultural factors relevant to disease, and, to some extent, with genetic predispositions to disease. Moreover, greater attention to the distinctive health conditions of certain racial and ethnic groups is necessary to make up for past neglect. But it will be a tricky business to steer a middle course between a naïve, reckless, or dogmatic color blindness and a stereotype-driven overreliance on race and ethnicity. In trying to steer such a course, the doctor can only hope for the day when a combination of more individualized genomic medicine and greater social equality will make it possible for her to pay less attention to race and ethnicity without detriment to her patients' health. (shrink)
There have been serious controversies in the latter part of the 20th century about the roles and functions of scientific and medical research. In whose interests are medical and biomedical experiments conducted and what are the ethical implications of experimentation on subjects unable to give competent consent? From the decades following the Second World War and calls for the global banning of medical research to the cautious return to the notion that in controlled circumstances, medical research on human subjects is (...) in the best interest of the given individual and the broader population, this book addresses the key implications of experimentation on humans. This volume covers major ethical themes within biomedical research providing historical, philosophical, legal and policy reflections on the literature and specific issues in the field of research on human subjects. Focusing on special populations (the elderly, children, prisoners and the cognitively impaired) it represents the most up-to-date review of the special ethical and legal conflicts that arise with relation to experimentation on subjects from these groups. In the light of current initiatives for law reform pertaining to research ethics the world over, this volume provides a timely, comprehensive and provocative exploration of the field. The volume has been carefully organized to present important philosophical perspectives on organizing principles that should underlie any practical application. A forward-looking historical review of the regulatory regimes of principal jurisdictions, including of the legal controls already in place, provides the backdrop for future policy initiatives. Additionally, in the light of global restructuring of health care systems, several chapters have been devoted to epidemiological research and related issues. (shrink)
George, B. J. Jr. The evolving law of abortion.--Guttmacher, A. F. The genesis of liberalized abortion in New York: a personal insight.--Callahan, D. Abortion: some ethical issues.--Jakobovits, I. Jewish views on abortion.--Drinan, R. F. The inviolability of the right to be born.--Schwartz, R. A. Abortion on request: the psychiatric implications.--Fleck, S. A psychiatrist's views on abortion.--Niswander, K. R. Abortion practices in the United States: a medical viewpoint.--Macintyre, M. N. Genetic risk, prenatal diagnosis, and selective abortion.--Messerman, G. A. Abortion counselling: shall (...) women be permitted to know?--Pilpel, H. F. and Zuckerman, R. J. Abortion and the rights of minors. (shrink)
Since its inception as an international requirement to protect patients and healthy volunteers taking part in medical research, informed consent has become the primary consideration in research ethics. Despite the ubiquity of consent, however, scholars have begun to question its adequacy for contemporary biomedical research. This book explores this issue, reviewing the application of consent to genetic research, clinical trials, and research involving vulnerable populations. For example, in genetic research, information obtained from an autonomous research participant may have significant bearing (...) on the interests of family members who have not consented to the study. This casts doubt on the adequacy of consent for such studies. This book also questions the assumptions that informed consent is essential and that it satisfactorily protects the principle of individual autonomy. It reviews recent empirical studies that challenge the possibility of truly informed consent and highlights the extent to which consent is governed by social norms and expectations. It also investigates how consent might be of secondary importance in some circumstances, for example when a research project appears to protect a public or community interest. (shrink)
Justice at Nuremberg traces the history of the Nuremberg Doctors' Trial held in 1946-47, as seen through the eyes of the Austrian bliogemigrbliogé psychiatrist Leo Alexander. His investigations helped the United States to prosecute twenty German doctors and three administrators for war crimes and crimes against humanity. The legacy of Nuremberg was profound. In the Nuremberg code--a landmark in the history of modern medical ethics--the judges laid down, for the first time, international guidelines for permissible experiments on humans. One of (...) those who helped to formulate the code was Alexander. Justice at Nuremberg provides a detailed insight into the origins of human rights in medical science and into the changing role of international law, ethics and politics. (shrink)
Machine generated contents note: Table of Cases xi -- Table of legislation xv -- Introduction: Medicine Men, Outlaws and Voluntary Euthanasia 1 -- 1. To Kill or not to Kill; is that the Euthanasia Question? 9 -- Introduction-Why Euthanasia? 9 -- Dead or alive? 16 -- Euthanasia as Homicide 25 -- Euthanasia as Death with Dignity 29 -- 2. Euthanasia and Clinically assisted Death: from Caring to Killing? 35 -- Introduction 35 -- The Indefinite Continuation of Palliative Treatment (...) 38 -- Withholding or Withdrawing Treatment 44 -- The Principle of Double Effect 54 -- Physician Assisted Suicide 60 -- Mercy Killing 64 -- Conclusions 66 -- 3. Consent to Treatment but Not to Death 69 -- Introduction-Why Consent? 69 -- Without Consent 70 -- Killing and Consent 73 -- Valid Consent, Freely Given? 74 -- Old Enough to Consent 80 -- Deciding for Others 82 -- Conclusions-A Consent Too Far? 93 -- 4. Autonomy, Self-determination and Self-destruction 95 -- Introduction-Autonomous Choices 95 -- Choosing to Die-Suicide and Autonomy 100 -- Suicidal Intentions 107 -- Autonomous Clinical Discretion 110 -- Deciding to Live or Die-Whose Decision? 112 -- 5. Living Wills and the Will to Die 115 -- Introduction 115 -- I Know My Will 118 -- This is My Will 121 -- I Will Decide 128 -- Will My Will be Done? 134 -- Where There's a Will 137 -- Conclusions 143 -- 6. Is Euthanasia a Dignified Death? 145 -- Introduction-Why Dignity? 145 -- Needing Dignity 146 -- Finding Dignity 149 -- Achieving Dignity in Dying 151 -- Dignifying Death 157 -- 7. Conclusions: Dignified Life, Dignified Death and Dignified Law 165 -- Select Bibliography 175 -- Index 183. (shrink)
This volume considers the many areas where medicine intersects with the law. Advances in medical research, reproductive science and genetics have given rise to unprecedented ethical and legal quandaries. These are reflected in chapters on cloning, organ donation, choosing genetic characteristics, and the use of Viagra.
El libro titulado “los avances del Derecho ante los avances de la medicina”, fruto de un Congreso internacional organizado por la Universidad Pontifica Comillas de Madrid en junio de 2008, recoge numerosos trabajos científicos en torno a cuatro grandes ámbitos en los que el legislador y el juzgador español están haciendo avanzar el Derecho al compás del avance en la ciencia médica: avances en la responsabilidad medica tanto civil, como patrimonial y penal; avances en la tutela de los derechos de (...) los pacientes, avances en los desafios jurídicos que plantea la investigación biomédica y avances en la seguridad de los pacientes. (shrink)
La obra recoge, desde una perspectiva interdisciplinar, las aportaciones de un grupo de investigadores españoles e italianos que han trabajado conjuntamente durante varios años en distintas cuestiones en torno a las posibilidades y riesgos de los avances biotecnológicos y su incidencia en el campo de los derechos humanos. Los estudios y debates se han realizado en el marco del programa de doctorado internacional sobre "Derechos humanos: Problemas actuales" encabezado por las Universidades de Valencia y Palermo. El Profesor Jesús Ballesteros, Catedrático (...) de Filosofía del Derecho en la Universidad de Valencia, ha sido el encargado de dirigir y coordinar este proyecto. (shrink)
The first IVF baby was born in the 1970s. Less than 20 years later, we had cloning and GM food, and information and communication technologies had transformed everyday life. In 2000, the human genome was sequenced. More recently, there has been much discussion of the economic and social benefits of nanotechnology, and synthetic biology has also been generating controversy. This important volume is a timely contribution to increasing calls for regulation - or better regulation - of these and other new (...) technologies. Drawing on an international team of legal scholars, it reviews and develops the role of human rights in the regulation of new technologies. Three controversies at the intersection between human rights and new technology are given particular attention. First, how the expansive application of human rights could contribute to the creation of a brave new world of choice, where human dignity is fundamentally compromised; second, how new technologies, and our regulatory responses to them, could be a threat to human rights; and, third, how human rights could be used to create better regulation of these technologies. (shrink)
Most people know precious little about the risks and benefits of participating in a clinical trial--a medical research study involving some innovative treatment for a medical problem. Yet millions of people each year participate anyway. Patients at Risk explains the reality: that our current system intentionally hides much of the information people need to make the right choice about whether to participate. Witness the following scenarios: -Hundreds of patients with colon cancer undergo a new form of keyhole surgery at leading (...) cancer centersnever -Tens of thousands of women at high risk of developing breast cancer are asked to participate in a major research study. They are told about the option of having both breasts surgically removed but not told about the option of taking a standard osteoporosis pill that might cut the risk of getting breast cancer by one-half or more. Patients at Risk written by two nationally prominent experts, is the first book to reveal the secrets that many in the research establishment have fought long and hard to keep from patients. It shows why options not commonly knownincluding getting a new treatment outside of a research studycan often be the best choice. It explains how patients can make good decisions even if there is only limited information about a treatments effect. And it does this through the eye-opening stories of what is happening daily to thousands of people. Day after day, we are learning how little we know about what really works. Headlines regularly announce that a previously unquestioned treatmenthormone replacement therapy, drugs such as Vioxx or Celebrexmay now be much riskier than we thought. The latest book in a surge of recent books criticizing the medical establishment (but the first to look at clinical trials specifically), Patients at Risk helps to empower patients to survive in a world of medical uncertainty, and makes positive recommendations for systemic reform. (shrink)
Machine generated contents note: 1. Introduction - when criminal law encounters bioethics: a case of tensions and incompatibilities or an apt forum for resolving ethical conflict? Amel Alghrani, Rebecca Bennett and Suzanne Ost; Part I. Death, Dying, and the Criminal Law: 2. Euthanasia and assisted suicide should, when properly performed by a doctor in an appropriate case, be decriminalised John Griffiths; 3. Five flawed arguments for decriminalising euthanasia John Keown; 4. Euthanasia excused: between prohibition and permission Richard Huxtable; Part II. (...) Freedom and Autonomy: When Consent Is Not Enough: 5. Body integrity identity disorder - a problem of perception? Robert Smith; 6. Risky sex and 'manly diversions': the contours of consent in criminal law - transmission and rough horseplay cases David Gurnham; 7. 'Consensual' sexual activity between doctors and patients: a matter for the criminal law? Suzanne Ost and Hazel Biggs; Part III. Criminalising Biomedical Science: 8. 'Scientists in the dock': regulating science Amel Alghrani and Sarah Chan; 9. Bioethical conflict and developing biotechnologies: is protecting individual and public health from the risks of xenotransplantation a matter for the (criminal) law? Sara Fovargue; 10. The criminal law and enhancement - none of the law's business? Nishat Hyder and John Harris; 11. Dignity as a socially constructed value Stephen Smith; Part IV. Bioethics and Criminal Law in the Dock: 12. Can English law accommodate moral controversy in medicine? The case of abortion Margaret Brazier; 13. The case for decriminalising abortion in Northern Ireland Marie Fox; 14. The impact of the loss of deference towards the medical profession Jose; Miola; 15. Criminalising medical negligence David Archard; 16. All to the good? Criminality, politics, and public health John Coggon; 17. Moral controversy, human rights and the common law judge Brenda Hale. (shrink)
Machine generated contents note: 1. Introduction - when criminal law encounters bioethics: a case of tensions and incompatibilities or an apt forum for resolving ethical conflict? Amel Alghrani, Rebecca Bennett and Suzanne Ost; Part I. Death, Dying, and the Criminal Law: 2. Euthanasia and assisted suicide should, when properly performed by a doctor in an appropriate case, be decriminalised John Griffiths; 3. Five flawed arguments for decriminalising euthanasia John Keown; 4. Euthanasia excused: between prohibition and permission Richard Huxtable; Part II. (...) Freedom and Autonomy: When Consent Is Not Enough: 5. Body integrity identity disorder - a problem of perception? Robert Smith; 6. Risky sex and 'manly diversions': the contours of consent in HIV transmission and rough horseplay cases David Gurnham; 7. 'Consensual' sexual activity between doctors and patients: a matter for the criminal law? Suzanne Ost and Hazel Biggs; Part III. Criminalising Biomedical Science: 8. 'Scientists in the dock': regulating science Amel Alghrani and Sarah Chan; 9. Bioethical conflict and developing biotechnologies: is protecting individual and public health from the risks of xenotransplantation a matter for the (criminal) law? Sara Fovargue; 10. The criminal law and enhancement - none of the law's business? Nishat Hyder and John Harris; 11. Dignity as a socially constructed value Stephen Smith; Part IV. Bioethics and Criminal Law in the Dock: 12. Can English law accommodate moral controversy in medicine? Lessons from abortion Margaret Brazier; 13. The case for decriminalising abortion in Northern Ireland Marie Fox; 14. The impact of the loss of deference towards the medical profession Jose; Miola; 15. Criminalising medical negligence David Archard; 16. All to the good? Criminality, politics, and public health John Coggon; 17. Moral controversy, human rights and the common law judge Brenda Hale. (shrink)
Lawyers write, blog and are otherwise producers of words; they structure public life through legal discourse and integrate all issues that reinforce legal reasoning. Even if one is inclined not to justify the power of their words in the context of a democratic theory, one is hardly able to challenge its public acceptance. But semiotic analyses harden the question whether these emperors wear nothing but robes. That attitude intensifies where medicine becomes increasingly relevant for legal discourse, as becomes clear (...) where for instance US political viewpoints bring bioethical issues to the Courts. One major theme in today’s medicine pertains to identity in its psychological, philosophical and social dimensions. Identity thus becomes a groundbreaking semiotic issue in law and medicine; both discourses are particular important to the otherness of the other. A US criminal law case interests here (Harrington v. State of Iowa, 2003; cited as: 659N.W.2d 509). The case is decided with “information about what the person has stored in his brain”. A chain of signs is involved: from “brain-function” to “brain-storage” via “brain-scan” to “brain-fingerprint”, for which the case became famous. A long series of signs and meanings belong here to intertwined discourses. Central is a particular sign in each discourse: “brain” means brain scan, and “fingerprint” means law! The two display trading mechanisms, which determine the otherness of the other and the self! The chain of signs in the Harrington case shows inter-disciplinarity in law and inter-discursivity among law and medicine. The trading itself underlines the semiotic dimensions in cyberspace, in particular the semiotics of the virtual (Hayles, Kurzweil) and their effects on legal discourse. (shrink)
This Major Reference series brings together a wide range of key international articles in law and legal theory. Many of these essays are not readily accessible, and their presentation in these volumes will provide a vital new resource for both research and teaching. Each volume is edited by leading international authorities who explain the significance and context of articles in an informative and complete introduction.
This essay examines the so-called phenomenon of defensive medicine and the problematic aspects of attempting to maintain the safest legal position possible. While physicians face genuine litigation threats they frequently overestimate legal peril. Many defensive practices are benign, but others alter patient care and increase costs in ways that are ethically suspect. Physicians should learn to evaluate realistically the legal risks of their profession and weigh the emotional, physical, and financial costs to the patient before employing a defensive measure.
This paper explores some of the important parallels between recent reforms to legal rules for the admissibility of scientific and expert evidence, exemplified by the US Supreme Court's decision in Daubert v Merrell Dow Pharmaceuticals, Inc. in 1993, and similar calls for reforms to medical practice, that emerged around the same time as part of the Evidence-Based Medicine (EBM) movement. Similarities between the “movements” can be observed in that both emerged from a historical context where the quality of (...) class='Hi'>medicine and legal approaches to science were being subjected to growing criticism, and in the ways that proponents of both movements have used appeals to “folk epistemologies” of science to help legitimate their reform aspirations. The term folk epistemology is used to describe the weaving together of formal and informal images of scientific method with normative and pragmatic concerns such as eradicating “junk science”, and promoting medical best practice. Perhaps unsurprisingly, given the unfocused breadth of these aspirations the implications of these “reforms” for medical and legal practice have not been straightforward, although they do represent an important new set of rhetorical resources to critique and or legitimate expertise in medical and legal domains. Discussion closes, by noting the growth of calls for these movements to reciprocate in areas where law and medicine intersect, such as medical negligence litigation. (shrink)
This paper describes the different dimensions of the relation between moral reflection and legislative processes. It discusses some examples of the institutionalisation of moral reflection. It is argued that the relation between ethics and law is still an actual and relevant question. Ethics also has to reflect on its own role in political life. The paper defends the relevance of a theological perspective on the relation between law and ethics. In the last part it is argued that the modality of (...) relation between ethics and law depends on the specific character of social domain. (shrink)