This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

In Medical Ethics, the editors have developed a completely different type book, focusing upon issues not ordinarily dealt with in texts on bioethics.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.2 (2000) 175-188 [Access article in PDF] Scope Note 38 Bioethics Resources on the Web * Once described as an "enormous used book store with volumes stacked on shelves and tables and overflowing onto the floor" (Pool, Robert. 1994. Turning an Info-Glut into a Library. Science 266 (7 October): 20-22, p. 20), Internet resources now receive numerous levels of organization, from basic directory listings (...) to elaborate "links" (cross-references to other Internet documents) that flash and glow in the dark. In many ways, the Internet functions as a direct extension of the traditional library. Following linked references across various sites is an electronic version of browsing library stacks, and the serendipitous discoveries made while "surfing the Net" recall the wonders of physically going "book-to-book." Although many of the Internet's best aspects augment library strengths by eliminating physical distance from sources, Net resources pose unique problems for researchers. It is not always clear who is responsible for the content of Web documents, when the document was produced, or how often (if ever) it is updated. Internet resource tools, then, must enable researchers to identify appropriate resources and to evaluate what they find when they get there. Web Research as Taking "Snapshots" Given the Internet's visual nature and fluid content, the process of conducting research on the Web has been likened to taking an informal picture of information on a specific date at a particular time. This metaphor also conveys the "zoom-in" aspect of searching through Web pages by going from general to specific categories. In the first section of this Scope Note, National Reference Center for Bioethics Literature (NRCBL) staff present a snapshot of bioethics resources taken during the spring months of 2000. Entries are divided into the categories of directories, electronic journals, full-text documents, news/current awareness, and teaching resources. In the two subsequent sections, this series of categories is repeated for entries on a specific topic within bioethics-genetics-and again for general search and evaluation tools. Where a Web site may contain pages applicable [End Page 175] to more than one category, multiple entries are made for that site with appropriate information for each category.Much as telecommunication advances have strengthened the relationship of patients and providers as partners, the dynamic nature of the Internet acknowledges that the researcher functions as a librarian whenever accessing the Web. It is our hope that BIOETHICSLINE and the other NRCBL databases not only will enable researchers to search the Web more efficiently, but also will help them to evaluate what they find when they get there. Bioethicsline on the Web: An International Plan in Progress Once only available through libraries, the U.S. National Library of Medicine (NLM), the funding agency for the ongoing development of the BIOETHICS LINE® database from the Kennedy Institute, has provided free Web access to that database of 63,000 citations since September 1998 through Internet Grateful Med. Plans are now underway to eliminate such specialty databases and incorporate all citations into PubMed (for journal articles) or LOCATORplus (for book-like materials and chapters in books). Both of these databases are likewise available at no cost on the Web. In the transition to PubMed and LOCATORplus some features of BIOETHICSLINE that presently are available may be lost. Researchers are encouraged to contact the National Reference Center for Bioethics Literature with search requests or for search strategy assistance with either the current or the future system ([email protected]).The inclusion of bioethics citations in PubMed and LOCATORplus will have several advantages. First, unique keywords from the Bioethics Thesaurus will be considered for inclusion in Medical Subject Headings (MeSH), the indexing vocabulary for PubMed and LOCATORplus, thereby enhancing retrieval of relevant clinical literature by offering more precise terminology covering ethical issues. Second, it will be easier to identify foreign-language materials, which are not currently included in the scope of BIOETHICSLINE. Third, the updating schedule will become more frequent. On the other hand, there may be some loss of searching precision because certain specialized features... (shrink)

The purpose of medical humanities is to improve the delivery of effective health care through a better understanding of disease in society, and in the individual. The interfaces between the science of medicine and the arts, philosophy, sociology and law interpret causes and effects of disease. The field of medical ethics is the most prominent offspring of this wider debate, yet the context of disease in the life of the individual and of society is profound and far-reaching. The influences of (...) medicine on the humanities and vice versa are all around, yet only recently have they been recognised in the wider world of health care. How can you encapsulate the essence of medical humanities and teach it to health professionals? Medical Humanities is designed to fill the need for a clear, well illustrated text that both provides the principles for the individual reader, and encourages discussion. The issues are explored in four main sections. Based on a highly successful seminar, and with contributions from leading writers, thinkers, and teachers, this book provides a comprehensive and authoritative reference for what is becoming a professional requirement in medicine. It will be invaluable for clinicians and students alike. (shrink)

"Many of today's moral conflicts concerning family values and medical ethics have their basis in different conceptions of man and the nature and purpose of human life. Fr Bristow argues that contemporary utilitarianism and the various forms of permissive morality are insufficient for dealing with these matters and that only a natural law morality is adequate to the needs and dignity of the human person. He goes on to apply its principles to the issues that derive from advancing technology, such (...) as genetic engineering, in vitrio fertilization, embryo research, drugs and painkillers and ecology."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

The field of medicine is generally greeted with great enthusiasm. This can be witnessed in the immense support for medical progress, which is widely hoped to lead to a realization of idealized goals. Indeed, with the help of medicine the human body would be controllable and constructible, human nature perfectible. However, enthusiasm in favor of medical progress is first and foremost a sentiment and, like all sentiments, not necessarily a product of rational contemplation. People are capable of enthusing about the (...) realization of utopian notions, such as life without disease or with the perfect body, without requiring any concrete arguments to back them up. Enthusiasm alone is not a guarantee of ethical desirability, however. Hence, this book takes a closer look at four research fields often referred to in medical utopian literature: 'tissue engineering', 'bioelectronics', 'germ line genome modification' and 'interventions in the biological aging process'. They serve as a basis for analyzing whether ethical arguments can be found to support the euphoric advocacy of the further development of these fields. (shrink)

Each book covers all the necessary information a beginner needs to know about a particular topic, providing an index for easy reference and using the series' ...

This is a slim, user friendly volume designed to introduce medical students and practicing clinicians to some basic issues of medical law and ethics, as well as to the ways in which lawyers and philosophers characteristically think. The book is divided into two parts: the first adumbrates the main ethical theories, some central ethical concepts, the role of law in society, and the English legal system ; the second part comprises chapters about key issues such as “consent”, “reproductive medicine”, and (...) “mental health”.This integration of ethics and law into such an accessible and tidy package is the main strength of the book. More weighty tomes have aimed for the same integration , but their scholarly density makes them more appropriate for reference than overview. The integration is important because there will always be certain students and practitioners who do not see …. (shrink)

Most experts would agree that the current medical malpractice system in the United States does not work effectively either to compensate victims fairly or prevent injuries caused by medical errors. Policy responses to a series of medical malpractice crises have not resulted in effective reform and have not altered the fundamental incentives of the stakeholders. In Medical Malpractice, economist Frank Sloan and lawyer Lindsey Chepke examine the U.S. medical malpractice process from legal, medical, economic, and insurance perspectives, analyze past efforts (...) at reform, and offer realistic, achievable policy recommendations. They review the considerable empirical evidence in a balanced fashion and assess objectively what works in the current system and what does not. Sloan and Chepke argue that the complexity of medical malpractice stems largely from the interaction of the four discrete markets that determine outcomes--legal, medical malpractice insurance, medical care, and government activity. After describing what the evidence shows about the functioning of medical malpractice, types of defensive medicine, and the effects of past reforms, they examine such topics as scheduling damages as an alternative to flat caps, jury behavior, health courts, incentives to prevent medical errors, insurance regulation, reinsurance, no-fault insurance, and suggestions for future reforms. Medical Malpractice is the most comprehensive treatment of malpractice available, integrating findings from several different areas of research and describing them accessibly in nontechnical language. It will be an essential reference for anyone interested in medical malpractice.Frank A. Sloan is J. Alexander McMahon Professor of Health Policy and Management and Professor of Economics at Duke University. He is the coauthor of The Price of Smoking and author or editor of many other books on health economics. Lindsey M. Chepke, an attorney, is a Research Associate at the Center for Health Policy at Duke University. (shrink)

This volume offers novel views on the precise relation between reference to an object by means of a linguistic expression and our mental representation of that object, long a source of debate in the philosophy of language, linguistics, and cognitive science. Chapters in this volume deal with our devices for singular reference and singular representation, with most focusing on linguistic expressions that are used to refer to particular objects, persons, or places. These expressions include proper names such as (...) Mary and John; indexicals such as I and tomorrow; demonstrative pronouns such as this and that; and some definite and indefinite descriptions such as The Queen of England or a medical doctor. Other chapters examine the ways we represent objects in thought, particularly the first-person perspective and the self, and one explores a notion common to reference and representation: salience. The volume includes the latest views on these complex topics from some of the most prominent authors in the field and will be of interest to anyone working on issues of reference and representation in thought and language. (shrink)

Discussions of over 200 selected ethical problems that face the practicing physician on a daily basis. Alphabetical arrangement of problems, ranging from abortion to Zen. Entry includes lengthy discussion and references.

There are at least two fundamental questions in medical ethics: What constitutes the ethical components associated with medical practice?; and How are these components realized in daily medical practice? This dissertation is concerned with question . In particular, focus is on daily medical linguistic practices of physicians. Due to the entailment of question in question , however, a brief answer for is also provided. Specifically, it is argued that a tripartite theoretical ethical framework is associated with medical practice, consisting of (...) consequentialist, deontological, and virtue ethics components. Turning towards daily medical linguistic practices, two daily medical linguistic practices are examined: ways of referring to patients and referring to disease. Both are addressed as they occur in the context of physician-physician dialogues in a clinical, hospital setting. In light of a background argument concerning the theoretical connection between language, worldview, and ethical perspective, in which language is shown to play a role in defining both worldview and ethical perspective, the ethical perspective of physicians qua medical language users is addressed. It is suggested that although medical practice has the tripartite normative ethical foundation in theory, the practical influence of medical language used for diagnosis is to impose an essentially consequentialist framework within which patients are conceived. Consistent with this limited ethical framework, disease language is noted to suggest connotations of certainty. In light of the ambiguous and uncertain character of medical encounters between physicians and patients, the implication of certainty by disease language is problematic. Likewise, the limited, essentially consequentialist perspective of physicians is inappropriate. Physicians must therefore recognize the limitations of disease language and refrain from solely using the kind of medical language which conceptually reduces patients to mere disease loci. Physicians will thus be better able to account for the ethical implications of medical practice. (shrink)

This is a practical, versatile, case-based introduction to bioethics for anyone interested in the ethical issues raised by modern medicine. It is designed to be used for individual reference, as well as a set text in group teaching or open learning environments. The workbook is structured around a variety of guided activities designed to introduce and examine the major ethical questions. The activities are clustered around actual cases (provided by an international team of health care professionals), commentaries (from clinicians, (...) ethicists, and lawyers), and short papers. The range of problems covered includes ethical issues raised by new reproductive and genetic technologies, the rights of vulnerable groups, and allocation of scarce medical resources. This workbook will be invaluable to practitioners, medical and nursing students, and anyone who needs to develop skills in ethical analysis for clinical practice or research. (shrink)

1. GENERAL The term "diagnostics" refers to the general theory of diagnosis, not to the study of specific diagnoses but to their general framework. It borrows from different sciences and from different philosophies. Traditionally, the general framework of diagnostics was not distinguished from the framework of medicine. It was not taught in special courses in any systematic way; it was not accorded special attention: students absorbed it intuitively. There is almost no comprehensive study of diagnostics. The instruction in diagnosis provided (...) in medical schools is exclusively specific. Clinical instruction includes (in addition to vital background information, such as anatomy and physiology) specific instruction in nosology, the theory and classification of diseases, and this includes information on diagnoses and prognoses of diverse diseases. What is the cause of the neglect of diagnostics, and of its integrated teaching? The main cause may be the prevalence of the view of diagnostics as part-and parcel of nosology. In this book nosology is taken as a given, autonomous field of study, which invites almost no comments; we shall freely borrow from it a few important general theses and a few examples. We attempt to integrate here three studies: ll of the way nosology is used in the diagnostic process; of the diagnostic process as a branch of applied ethics; ~ of the diagnostic process as a branch of social science and social technology. (shrink)

Approximately 200 entries to scientific or medical topics of interest because of their ethical or moral implications. Intended primarily for laypersons and professionals in the United Kingdom, but also throughout the world. Each entry gives definition, discussion (1-several pages), cross references, references, and contributor's name. 1st ed., 1977.

Doctor's Dilemmas, a fascinating study of the moral dilemmas confronting health professionals and patients alike, examines areas of health care where ethical conflicts often arise. Gorovitz illuminates these conflicts by clearly explaining and applying a broad range of philosophical concepts. He lays the groundwork for informed ethical decision-making and provides the general reader with a lucid overview of the complexities of medical practice. Written in accessible, conversational style and making extensive use of anecdotes, examples, and references to literature, Doctor's Dilemmas (...) offers profound insights into medical ethics for all those involved with the health professions--be they doctors, nurses, administrators, or patients. (shrink)

This book explores the scope, application and role of medical law, regulatory norms and ethics, and addresses key challenges introduced by contemporary advances in biomedical research and healthcare. While mindful of national developments, the handbook supports a global perspective in its approach to medical law. Contributors include leading scholars in both medical law and ethics, who have contributed specially commissioned pieces in order to present a critical overview and analysis of the current state of medical law and ethics. Each chapter (...) offers comprehensive coverage of longstanding and traditional topics in medical law and ethics, and offers dynamic insights into contemporary and emerging issues in this heavily debated field. Topics covered include: Bioethics, health and human rights Medical liability Law and emerging health technologies Public health law Personalized medicine The law and ethics of access to medicines in developing countries Medical research in the genome era Emerging legal and ethical issues in reproductive technologies This advanced level reference work will prove invaluable to legal practitioners, scholars, students and researchers in the disciplines of law, medicine, genetics, dentistry, theology, and medical ethics. (shrink)

Relatively new and now ubiquitous, smartphones and tablet computers are changing our lives by asking us to rethink the ways that we conduct business, form and maintain relationships, and read books and magazines. In the same capacity, mobile devices are redefining how health care is administered, monitored, and delivered through specialized technologies called medical apps (applications). In general, apps are pieces of software that can be installed and run on a variety of hardware platforms, including smartphones, tablets, laptops, and desktop (...) computers. Medical apps, in particular, refer to a wide variety of software that focuses on health care (loosely defined). Whether these apps target the health-care .. (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 medical ethics 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)

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)

Background Medical schools are grappling with how best to manage industry involvement in medical education.Objective To describe a case study of industry-supported undergraduate medical education related to opioid analgesics.Method Institutional case study.Results As part of their regular curriculum, Canadian medical students attended pain pharmacotherapy lectures that contained questionable content about the use of opioids for pain management. The lectures were supported by pharmaceutical companies that market opioid analgesics in Canada and the guest lecturer was a member of speakers bureaus of (...) the same companies. These conflicts of interests were not fully disclosed. A reference book that reinforced some of the information in the lectures and that was paid for by a sponsoring company was made available to students. This is the first report of an association between industry sponsorship and the dissemination of potentially dangerous information to medical students.Conclusions This case demonstrates the need for better strategies for preventing, identifying and dealing with problematic interactions between the pharmaceutical industry and undergraduate medical education. These might include the avoidance of unnecessary conflicts of interest, more disclosure of conflicts, an open process for dealing with recognised problems and internationally harmonised conflict of interest policies. (shrink)

The role of physicians in armed conflict -- International humanitarian law -- International criminal law -- Customary status of international humanitarian law -- The relevant human rights norms applicable to the work of physicians in armed conflict -- The interpretation of the reference to medical ethics and generally accepted medical standards pursuant to the Vienna Convention on the Law of Treaties -- Medical ethics in international law -- A pluralistic approach to medical ethics -- The documents by the World (...) Medical Association (WMA) -- Conclusion, recommendations and outlook. (shrink)

Challenges in Medical Care Edited by Andrew Grubb School of Law and Centre of Medical Law and Ethics, King’s College, London, UK The sixth volume in the series of King’s College Studies takes a reflective view of medical law and ethics, the health care system and challenges raised by modern technology. A distinguished team of authors returns to problems and controversies that have long challenged medical law and ethics, and shows how new issues are constantly arising as a result of (...) developments in medical care. Topics such as the legal status of the frozen human embryo, medical accountability and the future of the National Health Service are discussed. The need for responsibility, accountability and respect for individual human rights forms a strong linking theme throughout the book. This thought-provoking collection constitutes a useful and informative reference source which will be of value to a wide range of professionals and students including doctors, nurses, lawyers, philosophers and medical sociologists. (shrink)

It is better to exist than not to exist. That stage in the ontological argument can apply also to reference works: even if they display no more than a basic competence, their mere existence is extremely welcome. Of few scholarly fields can this be more true than of vernacular scientific writing in medieval England. Like their Latin counterparts, scientific and medical writings in Middle English are often anonymous or bear spurious attributions. They can be securely identified only by incipits. (...) Their sheer mutability defeats traditional editorial techniques. Hence the fundamental need for an approach to the corpus that focuses on individual manuscripts rather than on texts.Scholars of medieval Latin material have long enjoyed the benefits of “TK,” the Catalogue of Incipits of Mediaeval Scientific Writings in Latin , edited by Lynn Thorndike and Pearl Kibre . And they will soon enjoy the yet greater “searchability” of “eTK,” the revision in electronic form promised by its editor, Peter Murray Jones . No medieval vernacular has been comparably served. True, the relatively few scientific writings in Old English have each been studied intensively; and the Anglo‐Norman material has been rescued from oblivion almost single‐handedly by Tony Hunt. But apart from a few major translations from the Latin, the Middle English corpus—far more substantial than the Old English or the Anglo‐Norman—has remained, by comparison, poorly understood, largely because many of the manuscript witnesses have yet to be found and listed, let alone scrutinized.All this is about to change. If the editors of the work under review had merely scratched the surface in their cataloguing they would have earned our warmest thanks. But they have done much more than that. Since 1985, Linda Voigts and Patricia Kurtz have spent some ten years recording information on texts surviving in more than 1,200 manuscripts held in libraries and private collections in fifteen countries. Prologues and “embedded texts” are treated individually. The scope of the project is admirably broad and free of anachronism. To quote the editorial introduction: “We define medieval texts on medicine, science, and technology as those writings found in scientific and medical manuscripts. This is not a circular definition, for these books contain not only texts that are still judged to be medicine and science, but also many other writings considered science and medicine in the Middle Ages but not today [for example, computus and chiromancy].” The result is indexed by incipit, author, title, translator, TK equivalence, manuscript, and subject. Keyword searching of all these indexes, and of the bibliography, is of course easy. Invaluably, an “Index of Raw Data” allows the user to view incipits in the order in which they appear in the manuscripts. Even for a computer semiliterate such as myself, the database proved straightforward to install and navigate. Since it has been so many years in the compiling, its technology and design now seem a little primitive. But both are more than adequate to their task. Overall, this is a magnificent achievement; and, as the corrections and supplements pour in to the editorial office, “eVK” will become even more detailed and comprehensive. Its existence places the entire subject on a new footing. (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 Medical Ethics Workbook and definitions from the Dictionary of (...) Medical Ethics. (shrink)

This paper critically examines the metaphorical use of medical terms in philosophy. Three examples selected from distinct philosophical contexts demonstrate that such terms have been employed as metaphors both to describe the practice of philosophising and historically to diagnose philosophical positions. The selected examples are (i) the title of Avicenna’s main philosophical work, The Book of Healing, (ii) the criticism of medical metaphors in Enlightenment philosophy, and (iii) recent historical diagnoses in philosophy. The underlying epistemological assumptions of all three contexts (...) are reconstructed to critically analyse the medical metaphors. Through this tripartite synopsis, I arrive at a normative conclusions medical metaphors, such as the “healing of the soul” or “pathology of reason”, do not stand up to the critique of Enlightenment and are obsolete against the theoretical background of my reference texts. (shrink)

Is it lawful for a doctor to give a patient life-shortening pain relief? Can treatment be lawfully provided to a child under 16 on the basis of her consent alone? Is it lawful to remove food and water provided by tube to a patient in a vegetative state? Is a woman's refusal of a caesarean section recommended for the benefit of the fetus legally decisive? These questions were central to the four focal cases revisited in this book. This book revisits (...) nine landmark cases. For each, a new leading judgment is attributed to an imagined judge, Athena, who operates within the constraints of the legal system of England and Wales. Her judgments accord with an innovative legal theory, referred to as 'modified law as integrity', and are linked as a line of precedent. The result is a re-spinning of extant judicial threads into a web of legal principles with a greater claim to coherence and defensibility than those in the original cases. The book will be of great interest to scholars and students of medical law, criminal law, bioethics, legal theory and moral philosophy. (shrink)

Tort and contract law have not kept pace with the stunning changes in medicine's economics. Physicians are still expected to deliver the same standard of care to everyone, regardless whether it is paid for. Health plans increasingly face liability for unfortunate outcomes, even those stemming from society's mandate to keep costs down while improving population health. This book sorts through the chaos. After reviewing the inadequacies of current tort and contract law, Morreim proposes that an intelligent assignment of legal liability (...) must rest on an intelligent division of labor between health plans and providers, beginning with the question "who should be doing what, for the best delivery of health care." She also provides a comprehensive reference source of case law, commentary, and empirical literature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 545 Haroutunian, would have balked at the notion that their " empiricism " could be abstracted from the christological and trinitarian confession 0£ the church. In general, it would seem that a genuinely " empirical" approach would seek to engage the actual truth claims of religious com· munities on their own terms-even when those claims conflict with historicist suppositions. Second, in so far as Dean thinks there (...) is a uniquely American reli· gious experience or style of thought, privileging that style seems a dangerous move indeed. Dean is not unaware of the dangers. He specifically denies that he is engaging in any form of " American exceptionalism " (p. 25) ; it is simply that an " appropriately American historicism, centering on American culture, would have a greater chance of suggesting practices that work for and are true for America " (p. 24). But I am skeptical that such disclaimers address the real problem. Near the very end of the book, Dean suggests that a modi· fied naturalism might lead to " a notion of God that was more genuinely American than anything earlier," culminating in the recognition that " American thought about God is really the thought of a national com· munity" (p. 144). Descriptively that may well be the case; but then the Christian theologian must seek norms elsewhere. History Making History does not show us how historicist insigh~ might be incorporated into ecumenical, trinitarian theology, but that does not mean the attempt will prove unfruitful. Meanwhile, this bit of philosophical tale-telling will hold the interest of readers theological and otherwise. JOSEPH L. MANCINA Yale University New Haven, Connecticut Medical Ethics: Sources of Catholic Teaching. By KEVIN D. O'ROURKE, O.P. and PHILIP BOYLE, O.P. St. Louis: Catholic Health Associa· tion, 1989. Medical Ethics: Common Ground for Understanding. By KEVIN D. O'RouRKE, O.P. and DENNIS BRODEUR. St. Louis: Catholic Health Association, 1989. Healthcare Ethics: A Theological Analysis. By KEVIN D. O'RouRKE, O.P. and BENEDICT ASHLEY, O.P. 3rd ed. St. Louis: Catholic Health Association, 1989. Sources of Catholic Teaching is a compendium of recent "official" statements by Roman Catholic ecclesiastical bodies on issues concern· ing medical ethics. Arranged alphabetically according to topics, this col- 546 BOOK REVIEWS lection of statements from the papacy, the Roman Congregations, and the conferences of Catholic bishops could prove to he a very helpful reference tool. It contains a brief introduction which seeks to explain the role of these statements in the Catholic moral theology and Catholic medical ethics, a table of contents of the statements included, and then the statements themselves. In most instances it does not contain the entire document or statement hut only excerpts therefrom. There are some weaknesses in this work. First, these statements are not self-explanatory; they are in need of interpretation and explanation in many instances. But the authors present only the bald text and do not offer any explanatory comments. They apparently presume that these statements are pellucid to the reader, hut this is an unwarranted pre· sumption. For example, clarifying comments should have been added to the statement from the Declaration on Euthanasia because the allocution of Pius XII about giving lethal doses of analgesia is not entirely clear. A second difficulty with this work is the brief and somewhat insubstantial introduction on conscience and the role these statements should play in the formation of conscience. This sort of work invites a substantial and extended commentary on the nature of moral judgments, the relationship of conscience to the natural law, and the authority of these statements. The authors note that not all of the official statements issued by various organs of the Church are of equal authority, hut they do not try to identify the specific authoritative status of the various statements they include in their work. The reader is thus left to his or her own devices to determine, for example, the relative weight of statements of the administrative hoard of the NCCB versus statements of state episcopal conferences. A still further problem is that some of the statements are of virtually no significant authority for Catholics. For example, the statement of the administrative hoard of the NCCB on AIDS is of questionable... (shrink)

What the Doctor Didn’t Say, by Jerry Menikoff and Edward P. Richards, is a courageous and well-written volume that examines some of the fundamental debates pertaining to the ethics of clinical research. The volume deserves a careful reading by anyone with a potential role in clinical research: clinicians who might serve as investigators or refer patients to clinical trials; research staff; Institutional Review Board members and administrators; sponsors who design clinical trials; and the book’s intended audience, namely, potential research participants (...) and their families. A cursory reading of this volume might lead one to think that Menikoff and Richards have declared war on clinical research. They have not. Instead, they offer an in-depth study of the conduct and oversight of clinical research through the lens of law and ethics. They shed light on old issues and initiate discussion of new questions, challenging readers to think critically about the relationship between medical ethics, research ethics, the law, and the conduct of clinical research. (shrink)

This unique textbook utilizes an integrated, case-based approach to explore how the domains of bioethics, public health and the social sciences impact individual patients and populations. It provides a structured framework suitable for both educators (including course directors and others engaged in curricular design) and for medical and health professions students to use in classroom settings across a range of clinical areas and allied health professions and for independent study. The textbook opens with an introduction, describing the intersection of ethics (...) and public health in clinical practice and the six key themes that inform the book's core learning objectives, followed by a guide to using the book. It then presents 22 case studies that address a broad spectrum of patient populations, clinical settings, and disease pathologies. Each pair of cases shares a core concept in bioethics or public health, from community perspectives and end-of-life care to medical mistakes and stigma and marginalization. They engage learners in rigorous clinical and ethical reasoning by prompting readers to make choices based on available information and then providing additional information to challenge assumptions, simulating clinical decision-making. In addition to providing a unique, detailed clinical scenario, each case is presented in a consistent format, which includes learning objectives, questions and responses for self-directed learning, questions and responses for group discussion, references, and suggested further reading. All cases integrate the six themes of patient- and family-centered care; evidence-based practice; structural competency; biases in decision-making; cultural humility and awareness of the culture of medicine; and justice, social responsibility and advocacy. The final section discusses some challenges to evaluating courses and learning encounters that adopt the cases and includes a model framework for learner assessment. (shrink)

In accordance with standards published by the American Society for Bioethics and Humanities (ASBH), ethics consultants are expected to provide recommendations that align with scholarly literature, professional society statements, law, and policy. However, there are no studies to date that characterize the specific references that ethics consultants and educators use to inform their work. To address this gap, a convenience sample of clinical ethics consultants and educators was surveyed online through two major listservs for clinical ethics, the ASBH Clinical Ethics (...) Consultation Affinity Group (CECAG) and the Association of Bioethics Program Directors (ABPD). Ninety-five ethics consultants and/or educators with diverse educational background, credentials, and experience provided responses. In total, 451 references, 315 of which were unique, were reported. These references were broken into 6 categories after analysis: bioethics literature (divided into articles and books), professional society documents (divided into professional society statements and codes of ethics), federal/state/uniform/case law, hospital/health system policies, official religious teachings, and other. We found extensive variation and minimal overlap in the references respondents used for ethics consultation and education, even when referring to the same topics. Future research directions should include conducting more systematic efforts to characterize the references used by ethics consultants across the US; determining whether demographic characteristics of consultants influence the references used; and ascertaining whether the variation in references used reflects genuine disagreements in consultants’ and educators’ bioethical analysis or recommendations. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and (...) medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine by Laurence B. McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine ed. by Laurence B. McCullough, Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush by Lisbeth HaakonssenHeiner F. KlemmeLaurence B. McCullough. John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine. Dordrecht, (...) Boston, London: Kluwer Academic Publishers, 1998. Pp. xv + 347. Cloth, $140.00.Laurence B. McCullough, editor. John Gregory’s Writings on Medical Ethics and Philosophy of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xi + 254. Cloth, $105.00.Lisbeth Haakonssen. Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush. Amsterdam, Atlanta: Rodopi, 1997. Pp. x + 247. Paper, $20.50.The Scottish Enlightenment is widely appreciated for its contributions to philosophy, economics, sociology, law, chemistry, and medicine. The ideas and theories advanced by Hume, Smith, Millar, and Ferguson are still widely debated. John Gregory (1724–1773), important in his own time, is not as well known as some of his friends and colleagues. He was professor of medicine at the University of Edinburgh from 1766 to 1773, where he taught introductory lectures on the theory and practice of medicine. A set of extensive student notes from these lectures, entitled Observations on the Duties and Offices of a Physician, appeared anonymously in 1770. Two years later, Gregory himself published a revised version of his lectures under the title Lectures on the Duties and Qualifications of a Physician. These two books are said to mark the beginnings of professional medical ethics in the English-speaking world. They are also sometimes characterized as having anticipated bioethics.McCullough’s comprehensive John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine is the first modern intellectual biography of Gregory. Based on extensive research into eighteenth-century institutional context and the study of hitherto unknown manuscripts, he gives a full account of Gregory’s education at Edinburgh and Leiden, and his practice and teaching of medicine at Aberdeen, London, and Edinburgh. He stresses the importance of Gregory’s membership in the Aberdeen Philosophical Society and his close contact with Mrs. Montagu and her Circle for the understanding of his medical ethics. McCullough also shows that Bacon’s experimental method had a decisive influence on Gregory. Gregory took over Bacon’s three offices or ends of medicine: preservation of health, prolonging of life, and curing of diseases. In 1772, perhaps anticipating his premature death from hereditary gout, he added a fourth office, namely easing the pain of dying. Gregory referred mainly to Bacon (and Reid) in his Lectures to make clear how we can enlarge our medical knowledge by the method of experience and observation, pointing out that the progress of medicine had been seriously retarded by the way in which it was taught since Hippocrates. He also thought it was handicapped by the view that only professionals [End Page 535] should practice it, and claimed that even quacks have their advantages because their interest and reputation seldom suffer from the failure of the experiments necessary for the improvement of the medical profession.Gregory also argued that we should regard medicine not as a trade but as an art. In this context the principle of sympathy (or humanity) became important for him. Sympathy was the basis of the central duties in his Lectures. In a time of extreme instability of manners, when medicine was regarded more as a trade than an art, there was no physician-patient relationship based on the epistemological and moral authority of the physician. According to McCullough, it was Gregory who created “the physician-patient relationship as fiduciary. The virtues of the physician as fiduciary—openness to conviction, tenderness, and steadiness—provided for him the moral causes that would gather physicians together into a group worthy of the name, ‘profession,’ in its intellectual and moral senses” (265). The physician should no longer view his patients as moral strangers.McCullough claims that Gregory’s medical ethics is not just of historical interest, providing bioethics with its own history. It is also of... (shrink)

Arising from four conferences held in Europe and the United States, this volume contains eighteen essays written mostly by Roman Catholics with the exception of select contributions from Jewish, Protestant, and Orthodox perspectives. Most essays pay particular attention to the distribution of scarce medical resources in terms of intensive care units (ICUs) which use some 38% of all medical expenditures in the U.S. each year, one percent of the GNP. The essays often make reference to one another and a (...) wide variety of Catholic perspectives are represented. The essays offer a good reflection of the contemporary state of Catholic moral thought with its strengths and diversity and are nicely framed by the ‘outside voices’ of the non-Catholics represented. Philosophers will find some essays almost exclusively theological. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Enviornment 6.2 (2001) 114-118 [Access article in PDF] Book Review Child versus Childmaker: Future Persons and Present Duties in Ethics and the Law Child versus Childmaker: Future Persons and Present Duties in Ethics and the Law. Melinda A. Roberts. Lanham, Md.: Rowman & Littlefield, 1998. Pp. 235. ISBN 0-8476-8901-8 (Paperback) This book will provide the reader with a systematic examination of some of the most difficult (...) philosophical issues involved in procreation, and most notably those raised by wrongful life claims and the non-identity problem. Can an action without which a given child would not even exist be simultaneously said to harm this very child? This is the key question addressed in this book. It is relevant not only to bioethicists, but also to those concerned with the possibility of harming members of future generations in general. The author proceeds with remarkable clarity in three steps. First, she unveils the core intuition and unfolds the key implications of what is standardly referred to as the person-affecting view. Second, she focuses on the now famous non-identity problem that is supposed to raise a serious challenge to the plausibility of the person-affecting view. Third, wrongful life and human cloning are taken as illustrations of the problem.The starting point is thus the person-affecting or personalist view. The author argues that what is at stake in such a view is not only a concern for [End Page 114] persons (as opposed to plants or stones), but also for definite persons. The core intuition that "what is bad must be bad for someone" (Derek Parfit) implies a comparison between two states of the same person. As she puts it, "the pairwise comparisons of worlds appealed to within personalism are always in respect of particular people" (6). This does not necessarily imply consequentialism, contrary to what Roberts claims (e.g., 1), at least if we understand the latter, for example, as Philip Pettit does. 1 Moreover, one may very well argue that what is at the heart of the person-affecting intuition is a sense that an action needs to be assessed on the basis of its effect on persons, which would not necessarily imply that such effects require a comparison between two states of the same person. Nevertheless, the extent to which a person-affecting conception--as defined by Roberts--will be in trouble depends on the extent to which comparisons between the same person's states cannot operate. This is precisely where to introduce the idea of a non-identity context, that is, a situation in which not committing an allegedly harmful act would or could also have meant the nonexistence of the allegedly harmed person. For example, had a medical doctor not committed this preconceptional diagnostic mistake (or a father taken a slower or faster means of transportation to come back home), this child would or could not have existed. Can we thus say that the practitioner harmed the child who turned out to be heavily handicapped due, for example, to a genetically transmissible disease (or that the father harmed his child by leaving him with a very polluted environment due to his use of big cars as a means of transportation)?One key feature of Roberts's approach is that she restricts the scope of the non-identity problem to cases where not committing the allegedly harmful action would have made it impossible for this child to have existed ("two-alternative" cases) (26, 319, 325). This entails that whenever this very child could still have come to existence in the allegedly harmful action's absence, whatever the likelihood of such a coming to existence, we would fall outside a non-identity context ("three-alternative" cases) (27; 94-95). What matters to Roberts is whether or not the same child could have been born better than he is, not whether he would, as a matter of fact, have been born at all. The consequence is that in cases where the same child could have been born, say, unhandicapped, the author remains... (shrink)

The Bhagavad Gita is one of the most ancient, venerated and popular religious texts originating from India.1 It provides an excellent insight into the tenets of Hinduism. The Bhagavad Gita was originally a part of the Mahabharata,2 and was essentially a dialogue about ethical dilemmas and moral philosophies between a teacher (Krishna) and a disciple (Arjuna). It is considered one of the foundational and most important books in Hinduism. The text provides a synthesis of spiritualism and dharmic ideas, and this (...) text has found widespread acceptance across India, and in regions where there is a strong presence of an Indian diaspora or individuals who have embraced Hinduism. There are several words and sentences in the Bhagavad Gita that are of pertinence to ethics in general, but I believe that there is one in particular, that has a great degree of fit with medical ethics. I refer to the word amanitvam. This word amanitvam refers to humility, and it refers to a concept that Krishna advised Arjuna to embody. I strongly believe that this particular word is deeply applicable in a medical ethics context, and indeed, may help physicians become more …. (shrink)

This book explores the intersection of legal frameworks, healthcare innovation, and computational intelligence, shedding light on how emerging technologies like AI and ML are reshaping the medical landscape. It presents real life challenges such as patient privacy, data security, and compliance issues in smart healthcare by engaging into associated ethical and regulatory implications. Comprising the concepts of predictive analytics, regulatory compliance algorithms, and legal decision-making processes, this book offers a roadmap for stakeholders to navigate the evolving landscape of healthcare innovation (...) responsibly and ethically. Investigates how artificial intelligence supports legal decision-making processes in smart healthcare, addressing ethical and accountability concerns Demonstrates the use of smart contracts and automation tools powered by computational intelligence to streamline legal processes and ensure compliance in smart healthcare initiatives Focuses on managing healthcare data within legal frameworks, emphasizing computational intelligence's role in ensuring privacy and security. Examines how computational intelligence enables predictive analytics models to anticipate legal challenges and compliance issues in smart healthcare. Highlights the development and implementation of computational algorithms for navigating evolving legal frameworks in healthcare. This reference book is a useful resource for scholars and researchers working on smart healthcare. (shrink)

_What is psychotherapy about?_ _What are the similarities and differences of its many forms?_ _What are the most recent developments in the field?_ _Introduction to Psychotherapy_ has been an essential reference book since its publication in 1979, and is regularly included in reading lists for trainee psychotherapists, psychiatrists and other professionals. It is often recommended to interested lay people and prospective patients. This third edition takes into account recent changes in psychotherapy theory, practice and research. The authors are all (...) psychoanalysts. The first edition arose from the experiences of Dennis Brown and Jonathan Pedder working and teaching together as Consultant Psychotherapists at St Mary's Hospital and Medical School, London. (shrink)

Many health care undergraduate students would benefit from having a compact, comprehensive, and well organised focal text for their thinking about ethics that keeps the genuine complexities of the issues clearly in view. Some teachers find that certain well known works, such as Beauchamp and Childress’s Principles of Biomedical Ethics, are not satisfactory for this purpose, partly on account of their emphasis on specific theoretical positions that are not universally endorsed. But also the style of such “theory led” texts is (...) not always accessible to students, who tend to prefer less abstraction and more immediate demonstrations of clinical relevance. The approach taken by Mike Parker and Donna Dickenson in this workbook is an attempt to satisfy the demands of teachers and students in all these respects. Parker and Dickenson see this workbook as having several potential applications: as a resource for individual reference, and as a set text for group teaching, as well as providing materials for open learning (an area in which the authors have particular expertise). On the back of this flexibility, students in health care disciplines, qualified practitioners, as well as a non-professional audience, are all included in the book’s broad intended readership. Claims about “flexibility” can sometimes mask a lack of direction or specificity. But the authors have taken pains to ensure that their book does not suffer from these faults. Parker and Dickenson have integrated three basic kinds of material in the production of this workbook: case studies, commentaries, and activities. The case studies are presented in …. (shrink)

Today scientists are expected to be more accountable and transparent than at any time in history. Globally the pursuit of knowledge creation enjoys a place of distinction, and the public expects to reap considerable benefit from the innovative contributions made by researchers. It is therefore more important than ever that ethics, transparency and professionalism explicitly guide research integrity. Despite the clear importance of acquiring a fundamental understanding of clinical trials in the context of health research and innovation, medical training generally (...) fails to cover clinical trial integrity in its curriculum, including it neither at undergraduate nor at postgraduate levels. This new book provides a curriculum to address this gap, offering best practice guidelines to improve the quality, openness and trustworthiness of clinical trials and filling a current void in the market. Key Features: The first book on clinical trial integrity. Provides clear guidance on how to ensure probity in peer review, appraisal of trials and investigation of complaints concerning misconduct in clinical trials. Trains and supports researchers globally in how to undertake trials with integrity. Ensures the increasing demand for public documentation of all aspects throughout the lifecycle of a clinical trial can be met. The book is essential reading for master and doctoral students undertaking courses in clinical trials, epidemiology and medical statistics and an invaluable reference for medical journal editors and peer reviewers, clinicians who recruit patients into trials, pharmaceutical industry professionals, patient and public representatives who engage in clinical trials, systematic reviewers, guideline writers, funders and regulators of clinical trials. (shrink)

The idea of Greek influences on Hellenistic Judaism appears to be so deeply engrained within modern scholarship that nothing could upset this apple cart, at least as reflected in two recent books on various aspects of magic, astronomy, and medicine in Jewish sources from the Hellenistic and Roman periods. The usual frame of reference relies upon paradigms clearly outlined by Saul Lieberman and Martin Hengel, that Greek culture and science had penetrated Jewish thinking to such an extent, that even (...) Hebrew and Aramaic texts from Qumran or the Mishnah were eventually integrated into an undefined Hellenistic-Greek Jewish episteme. The present review article advocates an alternative Near Eastern context for Jew- ish writings in the period, one that did not reflect Hellenism in any form. (shrink)

This book critically examines some widespread views about the semantic phenomenon of reference and the cognitive phenomenon of singular thought. It begins with a defense of the view that neither is tied to a special relation of causal or epistemic acquaintance. It then challenges the alleged semantic rift between definite and indefinite descriptions on the one hand, and names and demonstratives on the other—a division that has been motivated in part by appeals to considerations of acquaintance. Drawing on recent (...) work in semantics, the book explores a more unified account of all four types of expression, according to which none of them paradigmatically fits the profile of a referential term. On the proposed framework, all four involve existential quantification but admit of uses that exhibit many of the traits associated with reference—a phenomenon that is due to the presence of what we call a ‘singular restriction’ on the existentially quantified domain. The book concludes by drawing out some implications of the proposed semantic picture for the traditional categories of reference and singular thought. (shrink)

From the care Plato takes in describing the excellence of the doctor in book 3 to the characterization of various pathological elements in the regimes he describes in book 8, the Republic teems with references to medical terms and concepts. The following investigates the breadth of the influence of medicine on the Republic. I argue that a medical vocabulary proves indispensable to indicating the relationship between philosophy and politics that the Republic envisages. In order to do so, this paper examines (...) the confluence of medicine and metaphysics revealed by a comparison between the discussion of the divided line and ancient characterizations of diagnosis. I then conclude with a reading of the Glaucus image in book 10 that emphasizes its self-diagnostic character. (shrink)