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.

Medical research involving human subjects raises complex ethical, legal and social issues. Investigators sometimes find that their obligations with respect to a research project come into conflict with their obligations to individual patients. The ethical conduct of research rests on 3 guiding principles: respect for persons, beneficience, and justice. Respect for persons underlies the duty to obtain informed consent from study participants. Beneficence demands a favourable balance between the potential benefits and harms of participation. Justice requires that vulnerable people not (...) be exploited and that eligible candidates who may benefit from participation not be excluded without good cause. Studies must be designed in a way that ensures the validity of findings and must address questions of sufficient importance to justify the risks of participation. In any clinical trial there must be genuine uncertainty as to which treatment arm offers the most benefit, and placebo controls should not be used if effective standard therapies exist. Researchers have a responsibility to inform themselves about the ethical, legal and policy standards that govern their activities. When difficulties arise, they should consult the existing literature and seek the advice of experts in research ethics. (shrink)

This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women's powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care (...) to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously‐based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women's reproductive self‐determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone‐marrow or blood donations for their children's survival. Women's unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity. (shrink)

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries (...) and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles. (shrink)

Demands by Patients or their Families for treatment thought to be inappropriate by health care providers constitute an important set of moral problems in clinical practice. A variety of approaches to such cases have been described in the literature, including medical futility, standard of care and negotiation. Medical futility fails because it confounds morally distinct cases: demand for an ineffective treatment and demand for an effective treatment that supports a controversial end (e.g., permanent unconsciousness). Medical futility is not necessary in (...) the first case and is harmful in the second. Ineffective treatment falls outside the standard of care, and thus health care workers have no obligation to provide it. Demands for treatment that supports controversial ends are difficult cases best addressed through open communication, negotiation and the use of conflict-resolution techniques. Institutions should ensure that fair and unambiguous procedures for dealing with such cases are laid out in policy statements. (shrink)

This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women's powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care (...) to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously‐based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women's reproductive self‐determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone‐marrow or blood donations for their children's survival. Women's unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity. (shrink)

Dickens’ famous satire of complacency and chauvinism entails a peculiarly English fiction about the innocence of girls. The “Podsnappery” chapter of Our Mutual Friend is in fact devoted to a dinner party in honor of Georgiana Podsnap’s eighteenth birthday, though “it was somehow understood…that nothing must be said about the day”1—the generation of Miss Podsnap being one of those disagreeable facts that Mr. Podsnap simply refuses to admit. But if Miss Podsnap’s birth is unmentionable, her existence is crucial: Podsnappery very (...) much depends upon the presence of a daughter. What Mr. Podsnap cannot dismiss as “Not English!”—starving Englishmen, for instance—can always be removed as subjects unsuited to the female young. The “cheek of the young person” becomes the test of knowledge over a wide field.1. Charles Dickens, Our Mutual Friend, ed. Stephen Gill , bk. 1, chap. 11, pp. 181-82; all further references to this work will be included parenthetically in the text with only book and chapter numbers for the convenience of those using other editions. (shrink)

How can literature, which consists of nothing more than the description of imaginary events and situations, offer any insight into the workings of "human reality" or "the human condition"? Can mere words illuminate something that we call "reality"? Bernard Harrison answers these questions in this profoundly original work that seeks to re-enfranchise reality in the realms of art and discourse. In an ambitious account of the relationship between literature and cognition, he seeks to show how literary fiction, by deploying (...) words against a background of imagined circumstances, allows us to focus on the roots, in social practice, of the meanings by which we represent our world and ourselves. Engaging with philosophers and theorists as diverse as Wittgenstein, Sartre, Merleau-Ponty, Foucault, Derrida, F. R. Leavis, Cleanth Brooks, and Stanley Fish, and illustrating his ideas through readings of works by Swift, Woolf, Appelfeld, and Dickens, among others, this book presents a systematic defense of humanism in literary studies, and of the study of the Humanities more generally, by a distinguished scholar. (shrink)

Bernard Dickens seeks to undermine the legal and ethical protections accorded to health care workers and hospitals conscientiously objecting to abortion. First, he appeals to the rationale of antidiscrimination laws as a basis for arguing against conscientious objection. Second, he argues that conscientious objection undermines the rights of patients and their autonomy. Third, he holds that conscientiously objecting doctors have a duty to refer patients for abortion. Fourth, he believes that Kant’s principle of respect for humanity as an end (...) in itself is violated by conscientious objection to abortion. Fifth, Dickens quotes remarks by Pope John Paul II as support for the idea that physicians should not conscientiously object to abortion. Finally, he posits that institutions, such as Catholic hospitals, have a responsibility to provide abortions. I argue that all of the arguments offered by Dickens against conscientious objection are unsound. (shrink)

The contributions of Professor Bernard Dickens to health law and bioethics span the era in which these fields have emerged as distinct domains of teaching, scholarship and professional and public conversation. Neither field exists in a vacuum. The concerns of bioethics, like the content of health law, are a product of social forces. The bureaucratization of medical care, the possibilities and uncertainties created by developments in medical technology, not to mention glaring health inequalities, have been destabilizing forces in medicine. (...) Writing in 1974, American sociologist Renée Fox noted that medicine had reached “a stage of development characterized by diffuse ethical and existential self-consciousness.” This new medical introspection was evidenced by intense engagement with issues of biomedical regulation, and with the growth of professional codes and processes for resolving value-laden issues within clinical settings.While sometimes described as a process or site for discussion and “engagement,” bioethics evolved rapidly into a domain of governance, with direct implications for clinical practice. (shrink)

The contributions of Professor Bernard Dickens to health law and bioethics span the era in which these fields have emerged as distinct domains of teaching, scholarship and professional and public conversation. Neither field exists in a vacuum. The concerns of bioethics, like the content of health law, are a product of social forces. The bureaucratization of medical care, the possibilities and uncertainties created by developments in medical technology, not to mention glaring health inequalities, have been destabilizing forces in medicine. (...) Writing in 1974, American sociologist Renée Fox noted that medicine had reached “a stage of development characterized by diffuse ethical and existential self-consciousness.” This new medical introspection was evidenced by intense engagement with issues of biomedical regulation, and with the growth of professional codes and processes for resolving value-laden issues within clinical settings.While sometimes described as a process or site for discussion and “engagement,” bioethics evolved rapidly into a domain of governance, with direct implications for clinical practice. (shrink)

How do we know right from wrong? Do we even have moral knowledge? Moral epistemology studies these and related questions about our understanding of virtue and vice. It is one of philosophy’s perennial problems, reaching back to Plato, Aristotle, Aquinas, Locke, Hume and Kant, and has recently been the subject of intense debate as a result of findings in developmental and social psychology. Throughout the book Zimmerman argues that our belief in moral knowledge can survive sceptical challenges. He also draws (...) on a rich range of examples from Plato’s Meno and Dickens’ David Copperfield to Bernard Madoff and Saddam Hussein. (shrink)

The first major consideration of old age in Western philosophy and literature since Simone de Beauvoir's The Coming of Age, Helen Small ranges widely from Plato through to recent work by Derek Parfit, Bernard Williams and others, and from King Lear through Balzac, Dickens, Beckett, Stevie Smith, Bellow, Roth, and Coetzee.

The last half century has been characterized by a growth in the regulation of clinical research nationally and internationally. Each area of research on human subjects has been the subject of a vast academic literature and extensive public policy debate, from issues of informed consent to that of regulatory structures. Professor Bernard Dickens has provided an outstanding contribution to this debate internationally through his many innovative and incisive papers in this area. This paper provides an English lawyer’s perspective upon (...) the increasing regulation of clinical research practices and asks – does regulation equate with effective rights protection? From Nuremberg onwards, there has been concern to ensure that research practices are ethical and in accordance with legal principles. So, for example, there have been statements such as the Declaration of Helsinki, which was initially produced in 1964. In the European context in particular, notably influential statements have been the European Convention on Human Rights, which has been followed by the Council of Europe Convention on Human Rights and Biomedicine and, more recently, a Draft Additional Protocol on medical research. (shrink)

This article explores decision making about social-ethical values issues by members of the public in the context of the recent Canadian federal election, held in late June 2004. All of these issues are sensitive and controversial, and I hesitated to address them in an article that I dedicate, with respect and admiration, to my friend and fellow medical lawyer-ethicist, Bernard Dickens. Over the years Bernie and I have discussed, debated and disagreed on many of them. It speaks to his (...) tolerance, reasonableness and wisdom that those occasions were for me always ones of learning and respect, colored by his inimitable sense of humor. I hope that Bernie feels that, in some small measure, this article reflects those same characteristics, ones that he has modeled for so many of us over the years of his distinguished career. (shrink)

The last half century has been characterized by a growth in the regulation of clinical research nationally and internationally. Each area of research on human subjects has been the subject of a vast academic literature and extensive public policy debate, from issues of informed consent to that of regulatory structures. Professor Bernard Dickens has provided an outstanding contribution to this debate internationally through his many innovative and incisive papers in this area. This paper provides an English lawyer’s perspective upon (...) the increasing regulation of clinical research practices and asks – does regulation equate with effective rights protection? From Nuremberg onwards, there has been concern to ensure that research practices are ethical and in accordance with legal principles. So, for example, there have been statements such as the Declaration of Helsinki, which was initially produced in 1964. In the European context in particular, notably influential statements have been the European Convention on Human Rights, which has been followed by the Council of Europe Convention on Human Rights and Biomedicine and, more recently, a Draft Additional Protocol on medical research. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o (...) improve medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o (...) improve medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

Insight is Bernard Lonergan's masterwork. It aim is nothing less than insight into insight itself, a comprehensive view of knowledge and understanding, and to state what one needs to understand and how one proceeds to understand it. In Lonergan's own words: 'Thoroughly understand what it is to understand, and not only will you understand the broad lines of all there is to be understood but also you will possess a fixed base, and invariant pattern, opening upon all further developments (...) of understanding.' The editors of the Collected Works of Bernard Lonergan have established the definitive text for Insight after examining all the variant forms in Lonergan's manuscripts and papers. The volume includes introductory material and annotation to enable the reader to appreciate more fully this challenging work. (shrink)

Moral problems do not always come in the form of great social controversies. More often, the moral decisions we make are made quietly, constantly, and within the context of everyday activities and quotidian dilemmas. Indeed, these smaller decisions are based on a moral foundation that few of us ever stop to think about but which guides our every action. Here distinguished philosopher Bernard Gert presents a clear and concise introduction to what he calls "common morality" -- the moral system (...) that most thoughtful people implicitly use when making everyday, common sense moral decisions and judgments. Common Morality is useful in that -- while not resolving every disagreement on controversial issues -- it is able to distinguish between acceptable and unacceptable answers to moral problems. In the first part of the book Gert lays out the fundamental features of common morality: moral rules, moral ideals, and a two-step procedure for determining when a violation of a moral rule is justified. Written in a non-technical style, the ten general moral rules include rules on which everyone can agree, such as "do not kill," "do not deceive," and "keep your promises." The moral ideals include similarly uncontroversial precepts such as "Relieve pain" and "Aid the needy." In the second part of the book Gert examines the underlying concepts that justify common morality, such as the notions of rationality and impartiality. The distillation of over 40 years of scholarship, this book is the most accessible version of Gert's influential theory of morality as well as an eye-opening look at the moral foundations of our everyday actions. Throughout the discussion is clear enough for a reader with little or no philosophy background. (shrink)

Presents Bernard Lonergan's five "verbum" articles that originally appeared in Theological studies. For Thomist students and scholars this "verbum" study offers a careful appraisal of the Thomist theory of knowledge as well as an introduction to the concepts found in Father Lonergan's "Insight". Since the concept of "verbum" dynamically affects the thought of Aquinas, it is necessary to grasp this concept to understand Thomist metaphysics and rational psychology. Lonergan has carefully analyzed and explicitly outlined "verbum"--An integral part of the (...) Thomist theory of knowledge. "Verbum" is examined as a tool of definition and for its impact on understanding, logical thought procession and related ideas stemming from "verbum". Discusses "the word" and its relation to abstraction. Focusses on St. Thomas' immediate concern in finding in Aristotle the point of insertion for Augustinian thought and in fusing a phenomenology of the subject with a psychology of the soul. (shrink)

This book is a philosophically sophisticated and scientifically well-informed discussion of the moral and social issues raised by genetically engineering animals, a powerful technology which has major implications for society. Unlike other books on this emotionally charged subject, the author attempts to inform, not inflame, the reader about the real problems society must address in order to manage this technology. Bernard Rollin is both a professor of philosophy, and physiology and biophysics, and writes from a uniquely well-informed perspective on (...) this topic. The style is non-technical and anecdotal and will ensure that the book can be used on a wide range of courses on bioethics, biotechnology, veterinary medicine and public policy. The book could also appeal to a general, non-academic reader with a serious interest in genetic engineering. (shrink)

From Bernard Boxill, professor of philosophy at the University of North Carolina at Chapel Hill and editor of Race and Racism, comes a tightly-argued, very illuminating book that will be essential reading for anyone interested in ...