Rethinking Health Care Ethics


Book Description

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.




Rethinking the Ethics of Clinical Research


Book Description

Clinical research requires that some people be used and possibly harmed for the benefit of others. What justifies such use of people? This book provides an in-depth philosophical analysis of several crucial issues raised by that question.Much writing on the ethics of research with human subjects assumes that participation in research is a distinctive activity that requires distinctive moral principles. In most contexts, we allow people to choose the activities in which they engage. By contrast, people are permitted to participate in research only after Institutional Review Boards determine that it is appropriate for them to do so. Although we assume that consent to participate in research must be preceded by an elaborate disclosure of information, we make no such assumption in many other areas of life. Although it is thought to be morally problematic to provide financial inducements to prospective subjects, we make no such assumptions when we hire people as loggers, fishermen, and fire fighters. Although we readily accept the "off-shoring" of manufacturing, many regard the off-shoring of medical research with great skepticism. This book seeks to widen the lens through which we consider such issues. When we do so, we will find that many standard principles of research ethics are difficult to defend.The book first argues that because respect for "autonomy" has been a central tenet of research ethics, many have failed to recognize that the structure of the regulation of research is deeply paternalistic and have therefore failed to justify such paternalism. The book then rejects "the autonomous authorization" model that characterizes most writing in bioethics and argues for a "fair transaction" model. Although many worry that the use of financial payment to recruit research subjects is coercive or constitutes an undue inducement, the book argues that most of those worries are misplaced. Shifting its attention to research in developing societies, the book considers the claim that international researchers exploit research abroad often exploits its subjects. Finally, the book considers the claim that because researchers benefit from their use of research subjects, they acquire special obligations to them or their communities.




Rethinking Life and Death


Book Description

In a reassessment of the meaning of life and death, a noted philosopher offers a new definition for life that contrasts a world dependent on biological maintenance with one controlled by state-of-the-art medical technology.




Rethinking Informed Consent in Bioethics


Book Description

Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics, first published in 2007, Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law.




Rethinking Autonomy


Book Description

Provides a critique of and alternative to the dominant paradigm used in biomedical ethics by exploring the Japanese concept of autonomy.




Tuskegee's Truths


Book Description

Between 1932 and 1972, approximately six hundred African American men in Alabama served as unwitting guinea pigs in what is now considered one of the worst examples of arrogance, racism, and duplicity in American medical research--the Tuskegee syphilis study. Told they were being treated for "bad blood," the nearly four hundred men with late-stage syphilis and two hundred disease-free men who served as controls were kept away from appropriate treatment and plied instead with placebos, nursing visits, and the promise of decent burials. Despite the publication of more than a dozen reports in respected medical and public health journals, the study continued for forty years, until extensive media coverage finally brought the experiment to wider public knowledge and forced its end. This edited volume gathers articles, contemporary newspaper accounts, selections from reports and letters, reconsiderations of the study by many of its principal actors, and works of fiction, drama, and poetry to tell the Tuskegee story as never before. Together, these pieces illuminate the ethical issues at play from a remarkable breadth of perspectives and offer an unparalleled look at how the study has been understood over time.




An Ethic for Health Promotion


Book Description

What is the goal of public health promotion today? If the leading causes of mortality nowadays are primarily attributable to lifestyle behaviors, is the purpose of research to develop the power to change those behaviors, in the same way that science has been able to control infectious diseases? Or is the quest for effective behavior modification techniques antithetical to the idea of promoting well-being defined in terms of individual autonomy, dignity, and integrity. An Ethic for Health Promotion explores these questions.




Rethinking Medical Ethics


Book Description

In this unique study, Jean-Pierre Clero examines medical ethics from a philosophical perspective. Based on the thoughts of great philosophers, he develops a theory of medical ethics that focuses on the values of intimacy.




Rethinking the Good


Book Description

In choosing between moral alternatives -- choosing between various forms of ethical action -- we typically make calculations of the following kind: A is better than B; B is better than C; therefore A is better than C. These inferences use the principle of transitivity and are fundamental to many forms of practical and theoretical theorizing, not just in moral and ethical theory but in economics. Indeed they are so common as to be almost invisible. What Larry Temkin's book shows is that, shockingly, if we want to continue making plausible judgments, we cannot continue to make these assumptions. Temkin shows that we are committed to various moral ideals that are, surprisingly, fundamentally incompatible with the idea that "better than" can be transitive. His book develops many examples where value judgments that we accept and find attractive, are incompatible with transitivity. While this might seem to leave two options -- reject transitivity, or reject some of our normative commitments in order to keep it -- Temkin is neutral on which path to follow, only making the case that a choice is necessary, and that the cost either way will be high. Temkin's book is a very original and deeply unsettling work of skeptical philosophy that mounts an important new challenge to contemporary ethics.




Rethinking Moral Status


Book Description

Common-sense morality implicitly assumes that reasonably clear distinctions can be drawn between the full moral status that is usually attributed to ordinary adult humans, the partial moral status attributed to non-human animals, and the absence of moral status, which is usually ascribed to machines and other artifacts. These implicit assumptions have long been challenged, and are now coming under further scrutiny as there are beings we have recently become able to create, as well as beings that we may soon be able to create, which blur the distinctions between human, non-human animal, and non-biological beings. These beings include non-human chimeras, cyborgs, human brain organoids, post-humans, and human minds that have been uploaded into computers and onto the internet and artificial intelligence. It is far from clear what moral status we should attribute to any of these beings. There are a number of ways we could respond to the new challenges these technological developments raise: we might revise our ordinary assumptions about what is needed for a being to possess full moral status, or reject the assumption that there is a sharp distinction between full and partial moral status. This volume explores such responses, and provides a forum for philosophical reflection about ordinary presuppositions and intuitions about moral status.