In this book, Norman Cantor analyzes the legal and moral status of people with profound mental disabilities—those with extreme cognitive impairments that prevent their exercise of medical self-determination. He proposes a legal and moral framework for surrogate medical decision making on their behalf. The issues Cantor explores will be of interest to professionals in law, medicine, psychology, philosophy, and ethics, as well as to parents, guardians, and health care providers who face perplexing issues in the context of surrogate medical decision making.
This examination of end-of-life decision making offers a broader perspective than that found in the extensive existing literature on this topic by offering a cross-national comparison. Experts from twelve countries analyze death-related issues and policies in their respective nations, discussing such topics as health care costs, advance directives or wills, pain management, and cultural, social, and religious factors.
Is DNA technology the ultimate diviner of guilt or the ultimate threat to civil liberties? Over the past decade, DNA has been used to exonerate hundreds and to convict thousands. Its expanded use over the coming decade promises to recalibrate significantly the balance between collective security and individual freedom. For example, it is possible that law enforcement DNA databases will expand to include millions of individuals not convicted of any crime.
As our scientific and technical abilities expand at breathtaking speeds, concern that modern genetics and bioengineering are leading us to a posthuman future is growing. Is Human Nature Obsolete? poses the overarching question of what it is to be human against the background of these current advances in biotechnology. Its perspective is philosophical and interdisciplinary rather than technical; the focus is on questions of fundamental ontological importance rather than the specifics of medical or scientific practice.
Definitions of health and disease are of more than theoretical interest. Understanding what it means to be healthy has implications for choices in medical treatment, for ethically sound informed consent, and for accurate assessment of policies or programs. This deeper understanding can help us create more effective public policy for health and medicine. It is notable that such contentious legal initiatives as the Americans with Disability Act and the Patients' Bill of Rights fail to define adequately the medical terms on which their effectiveness depends.
Insurance companies routinely use an individual's medical history and family medical history in determining eligibility for life insurance; this is part of the process of medical underwriting. Insurers have also long used genetic information, often derived from family history, in underwriting. But rapid advances in gene identification and genetic testing are changing the way we look at genetic information. Should the results of genetic testing (which might identify a predisposition toward disease not related to medical history) be available to life insurance medical underwriters?
This textbook for instruction in biomedical research ethics can also serve as a valuable reference for professionals in the field of bioethics. The 149 cases included in the book are grouped in nine chapters, each of which covers a key area of debate in the field. Some of the case studies are classics, including the famous cases of the Tuskegee Syphilis Study (in which subjects with syphilis were not given treatment) and the Willowbrook hepatitis studies (in which institutionalized subjects were intentionally exposed to hepatitis).
The idea of the gene has been a central organizing theme in contemporary biology, and the Human Genome project and biotechnological advances have put the gene in the media spotlight. In this book Lenny Moss reconstructs the history of the gene concept, placing it in the context of the perennial interplay between theories of preformationism and theories of epigenesis. He finds that there are not one, but two, fundamental—and fundamentally different—senses of "the gene" in scientific use—one the heir to preformationism and the other the heir to epigenesis.
Modern scientific and medical advances bring new complexity and urgency to ethical issues in health care and biomedical research. This book applies the American philosophical theory of pragmatism to such bioethics. Critics of pragmatism argue that it lacks a universal moral foundation. Yet it is this very lack of a metaphysical dividing line between facts and values that makes pragmatism such a rigorous and appropriate method for solving problems in bioethics.
The war on terrorism and the threat of chemical and biological weapons have brought a new urgency to already complex moral and bioethical questions. In the Wake of Terror presents thought-provoking essays on many of the troubling issues facing American society, written by experts from the fields of medicine, health care policy, law, political science, history, philosophy, and theology.
Engendering International Health presents the work of leading researchers on gender equity in international health. Growing economic inequalities reinforce social injustices, stall health gains, and deny good health to many. In particular, deep-seated gender biases in health research and policy institutions combine with a lack of well-articulated and accessible evidence to downgrade the importance of gender perspectives in health.
The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy.
Human embryonic stem cells can divide indefinitely and have the potential to develop into many types of tissue. Research on these cells is essential to one of the most intriguing medical frontiers, regenerative medicine. It also raises a host of difficult ethical issues and has sparked great public interest and controversy.
Although managed health care is a hot topic, too few discussions focus on health care rationing—who lives and who dies, death versus dollars. In this book, physician and bioethicist Peter A. Ubel argues that physicians, health insurance companies, managed care organizations, and governments need to consider the cost-effectiveness of many new health care technologies. In particular, they need to think about how best to ration health care.
In recent years, bioethicists have worked on government commissions, on ethics committees in hospitals and nursing homes, and as bedside consultants. Because ethical knowledge is based on experience within the field rather than on universal theoretical propositions, it is open to criticism for its lack of theoretical foundation. Once in the clinic, however, ethicists noted the extent to which medical practice itself combined the certitudes of science with craft forms of knowledge.
In May 2013, after months of controversy, France legalized same-sex marriage and adoption by homosexual couples. Obstacles to adoption and parenting equality remain, however—many of them in the form of cultural and political norms reflected and expressed in French adoption policies. In The Politics of Adoption, Bruno Perreau describes the evolution of these policies. In the past thirty years, Perreau explains, political and intellectual life in France have been dominated by debates over how to preserve “Frenchness," and these debates have driven policy making.
This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions.