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Patient Safety and Policy Reform
According to a recent Institute of Medicine report, as many as 98,000 Americans die each year as a result of medical error -- a figure higher than deaths from automobile accidents, breast cancer, or AIDS. That astounding number of fatalities does not include the number of those serious mistakes that are grievous and damaging but not fatal. Who can forget the tragic case of 17-year-old Jésica Santillán, who died after receiving a heart-lung transplant with an incompatible blood type? What can be done about this? What should be done? How can patients and their families regain a sense of trust in the hospitals and clinicians that care for them? Where do we even begin the discussion?
Accountability brings the issue to the table in response to the demand for patient safety and increased accountability regarding medical errors. In an interdisciplinary approach, Virginia Sharpe draws together the insights of patients and families who have suffered harm, institutional leaders galvanized to reform by tragic events in their own hospitals, philosophers, historians, and legal theorists. Many errors can be traced to flaws in complex systems of health care delivery, not flaws in individual performance. How then should we structure responsibility for medical mistakes so that justice for the injured can be achieved alongside the collection of information that can improve systems and prevent future error? Bringing together authoritative voices of family members, health care providers, and scholars -- from such disciplines as medical history, economics, health policy, law, philosophy, and theology -- this book examines how conventional structures of accountability in law and medical structure (structures paradoxically at odds with justice and safety) should be replaced by more ethically informed federal, state, and institutional policies. Accountability calls for public policy that creates not only systems capable of openness concerning safety and error -- but policy that also delivers just compensation and honest and humane treatment to those patients and families who have suffered from harmful medical error.
Health, Disease, Poverty
Affliction inaugurates a novel way of understanding the trajectories of health and disease in the context of poverty. Focusing on low-income neighborhoods in Delhi, it stitches together three different sets of issues. _x000B__x000B_First, it examines the different trajectories of illness: What are the circumstances under which illness is absorbed within the normal and when does it exceed the normal—putting resources, relationships, and even one’s world into jeopardy? _x000B__x000B_A second set of issues involves how different healers understand their own practices. The astonishing range of practitioners found in the local markets in the poor neighborhoods of Delhi shows how the magical and the technical are knotted together in the therapeutic experience of healers and patients. The book asks: What is expert knowledge? What is it that the practitioner knows and what does the patient know? How are these different forms of knowledge brought together in the clinical encounter, broadly defined? How does this event of everyday life bear the traces of larger policies at the national and global levels? _x000B__x000B_Finally, the book interrogates the models of disease prevalence and global programming that emphasize surveillance over care and deflect attention away from the specificities of local worlds. Yet the analysis offered retains an openness to different ways of conceptualizing “what is happening” and stimulates a conversation between different disciplinary orientations to health, disease, and poverty._x000B__x000B_Most studies of health and disease focus on the encounter between patient and practitioner within the space of the clinic. This book privileges, instead, the networks of relations, institutions, and knowledge over which the experience of illness is dispersed. Instead of thinking of illness as an event set apart from everyday life, it shows the texture of everyday life, the political economy of neighborhoods, as well as the dark side of care. It helps us see how illness is bound by the contexts in which it occurs, while also showing how illness transcends these contexts to say something about the nature of everyday life and the making of subjects.
This is a vivid, thought-provoking and fascinating text on some contentious issues in contemporary medical ethics. The book acknowledges the contribution of ìAfrican traditionî and Western scholarship to the development of medical ethics as a university discipline. It questions the lack of consensus around such biomedical issues as euthanasia and traditional medicine. In many countries, the failure has resulted in public outcries. Its thrust centres on the nexus of practice and theory, and the importance of pragmatism and critical questioning in dealing with different cases on and around biomedicine. Its virtue is its significant shift from the traditional positions on selected biomedical issues to a more rigorous, pragmatic and critical questioning and understanding of the reasoning and positions of all involved and/or affected parties.
Culture, Race, and Identity
Do people of differing ethnicities, cultures, and races view medicine and bioethics differently? And, if they do, should they? Are doctors and researchers taking environmental perspectives into account when dealing with patients? If so, is it done effectively and properly? In African American Bioethics, Lawrence J. Prograis Jr. and Edmund D. Pellegrino bring together medical practitioners, researchers, and theorists to assess one fundamental question: Is there a distinctive African American bioethics? The book's contributors resoundingly answer yesùyet their responses vary. They discuss the continuing African American experience with bioethics in the context of religion and tradition, work, health, and U.S. society at largeùfinding enough commonality to craft a deep and compelling case for locating a black bioethical framework within the broader practice, yet recognizing profound nuances within that framework. As a more recent addition to the study of bioethics, cultural considerations have been playing catch-up for nearly two decades. African American Bioethics does much to advance the field by exploring how medicine and ethics accommodate differing cultural and racial norms, suggesting profound implications for growing minority groups in the United States.
Medical Error and the Ethics of Forgiveness
Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and models. In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers.
The Life and Times of the Human Cadaver
What will become of our earthly remains? What happens to our bodies during and after the various forms of cadaver disposal available? Who controls the fate of human remains? What legal and moral constraints apply? Legal scholar Norman Cantor provides a graphic, informative, and entertaining exploration of these questions. After We Die chronicles not only a corpse's physical state but also its legal and moral status, including what rights, if any, the corpse possesses.
In a claim sure to be controversial, Cantor argues that a corpse maintains a "quasi-human status" granting it certain protected rights -- both legal and moral. One of a corpse's purported rights is to have its predecessor's disposal choices upheld. After We Die reviews unconventional ways in which a person can extend a personal legacy via their corpse's role in medical education, scientific research, or tissue transplantation. This underlines the importance of leaving instructions directing post-mortem disposal. Another cadaveric right is to be treated with respect and dignity. After We Die outlines the limits that "post-mortem human dignity" poses upon disposal options, particularly the use of a cadaver or its parts in educational or artistic displays.
Contemporary illustrations of these complex issues abound. In 2007, the well-publicized death of Anna Nicole Smith highlighted the passions and disputes surrounding the handling of human remains. Similarly, following the 2003 death of baseball great Ted Williams, the family in-fighting and legal proceedings surrounding the corpse's proposed cryogenic disposal also raised contentious questions about the physical, legal, and ethical issues that emerge after we die. In the tradition of Sherwin Nuland's How We Die, Cantor carefully and sensitively addresses the post-mortem handling of human remains.
Vol. 1 (2001) - vol. 4, no. 2 (2004)
AJOB provides a rapid, peer-reviewed collection of scholarship about emerging issues in bioethics. The Journal is available in a unique print and internet format. Subscribers receive access to the ajobonline portal, which features on-line news updates, live bioethics events, rankings of bioethics graduate programs, and other materials.
The Catholic Debate
During the past few decades, high-profile cases like that of Terry Schiavo have fueled the public debate over forgoing or withdrawing artificial nutrition and hydration from patients in a persistent vegetative state (PVS). These cases, whether involving a
Inaugural edition (2008); Vol. 1 (2009) through current issue
The Asian Bioethics Review covers a broad range of topics relating to bioethics. An online academic journal, ABR provides a forum to express and exchange original ideas on all aspects of bioethics, especially those relevant to the region. The journal promotes multi-cultural and multi-disciplinary studies and will appeal to all working in the field of ethics in medicine and healthcare, genetics, law, policy, science studies and research.
A Study in Culture, Ethnography, and Religion
"Dr. Farhat Moazam has written a wonderful book, based on her extraordinary first-hand study.... [S]he is an exceptionally gifted and evocative writer. Her book not only has the attributes of a superb piece of intellectual work, but it has literary artistic merit." -- Renee C. Fox, Annenberg Professor Emerita of the Social Sciences at the University of Pennsylvania
This is an ethnographic study of live, related kidney donation in Pakistan, based on Farhat Moazam's participant-observer research conducted at a public hospital. Her narrative is both a "thick" description of renal transplant cases and the cultural, ethical, and family conflicts that accompany them, and an object lesson in comparative bioethics.