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Genomics and Environmental Regulation

Science, Ethics, and Law

edited by Richard R. Sharp, Gary E. Marchant, and Jamie A. Grodsky

To reduce the deleterious effects of environmental contamination, governments across the world have enacted regulations broadly conceived for entire populations. Information arising out of the Human Genome Project and other cutting-edge genetic research is shifting the policymaking process. This fascinating volume draws on experts from academia, government, industry, and nongovernmental organizations to examine the science of genomic research as applied to environmental policy. The first section explores environmental policy applications, including subpopulation genetic profiling, industrial regulations, and standardizing governmental evaluation of genomic data. The second section assesses from multiple angles the legal framework involved in applying genomics to environmental regulation. In the third section, the contributors review closely the implications of genomic research for occupational health, from disease prevention and genetic susceptibility to toxicants, to workers’ rights and potential employment discrimination. A fourth section explores the bioethical and philosophical complications of bringing genetic data and research into nonclinical regulatory frameworks. Genomics and Environmental Regulation points to ways in which information on toxicology and genetics can be used to craft more precise and efficient regulations.

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The Goals of Medicine

The Forgotten Issues in Health Care Reform

Mark J. Hanson and Daniel Callahan, Editors

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical students.

The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health.

The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless.

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Handbook for Health Care Ethics Committees

Linda Farber Post and Jeffrey Blustein

The Joint Commission (TJC) accredits and certifies more than 19,000 health care organizations in the United States, including hospitals, nursing homes, and home care agencies. Each organization must have a standing health care ethics committee to maintain its status. These interdisciplinary committees are composed of physicians, nurses, attorneys, ethicists, administrators, and interested citizens. Their main function is to review and provide resolutions for specific, individual patient care problems. Many of these committees are well meaning but may lack the information, experience, skills, and formal background in bioethics needed to adequately negotiate the complex ethical issues that arise in clinical and organizational settings. Handbook for Health Care Ethics Committees was the first book of its kind to address the myriad responsibilities faced by ethics committees, including education, case consultation, and policy development. Adopting an accessible tone and using a case study format, the authors explore serious issues involving informed consent and refusal, decision making and decisional capacity, truth telling, the end of life, palliative care, justice in and access to health care services, and organizational ethics. The authors have thoroughly updated the content and expanded their focus in the second edition to include ethics committees in other clinical settings, such as long-term care facilities, small community hospitals, rehabilitation centers, and hospices. They have added three new chapters that address reproduction, disability, and the special needs of the elder population, and they provide additional specialized policies and procedures on the book’s website. This guide is an essential resource for all health care ethics committee members.

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Handbook of Medical Sociology, Sixth Edition

Edited by Chloe E. Bird, Peter Conrad, Allen M. Fremont, and Stefan Timmermans

Composed entirely of specially commissioned chapters by some of the outstanding scholars in medical sociology, this edition reflects important changes in the study of health and illness. In addition to updated and reconceived chapters on the impacts of gender, race, and inequality on health, this volume has new chapters on topics that include: --social networks, neighborhoods, and social capital --disability --dying and "the right to die" --health disparities --the growing influence of the pharmaceutical industry --patient safety --evidence-based medicine and quality of care --health social movements --genetics --religion, spirituality, and health

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Hastings Center Report

Vol. 35 (2005) - vol. 41 (2011)

The Hastings Center Report is a leading journal in bioethics featuring original scholarship and commentary on issues in health, medicine, medical research, and biotechnology as they affect individuals, communities, and societies. It is published by The Hastings Center, an independent, nonpartisan, and nonprofit organization.

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Health and Human Flourishing

Religion, Medicine, and Moral Anthropology

Carol R. Taylor and Roberto Dell’Oro, Editors

What, exactly, does it mean to be human? It is an age-old question, one for which theology, philosophy, science, and medicine have all provided different answers. But though a unified response to the question can no longer be taken for granted, how we answer it frames the wide range of different norms, principles, values, and intuitions that characterize today's bioethical discussions. If we don't know what it means to be human, how can we judge whether biomedical sciences threaten or enhance our humanity? This fundamental question, however, receives little attention in the study of bioethics. In a field consumed with the promises and perils of new medical discoveries, emerging technologies, and unprecedented social change, current conversations about bioethics focus primarily on questions of harm and benefit, patient autonomy, and equality of health care distribution. Prevailing models of medical ethics emphasize human capacity for self-control and self-determination, rarely considering such inescapable dimensions of the human condition as disability, loss, and suffering, community and dignity, all of which make it difficult for us to be truly independent. In Health and Human Flourishing, contributors from a wide range of disciplines mine the intersection of the secular and the religious, the medical and the moral, to unearth the ethical and clinical implications of these facets of human existence. Their aim is a richer bioethics, one that takes into account the roles of vulnerability, dignity, integrity, and relationality in human affliction as well as human thriving. Including an examination of how a theological anthropologyùa theological understanding of what it means to be a human beingùcan help us better understand health care, social policy, and science, this thought-provoking anthology will inspire much-needed conversation among philosophers, theologians, and health care professionals.

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Health Care as a Social Good

Religious Values and American Democracy

David M. Craig

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The Health Care Professional as Friend and Healer

Building on the Work of Edmund D. Pellegrino

David C. Thomasma and Judith Lee Kissell, Editors

This book illuminates issues in medical ethics revolving around the complex bond between healer and patient, focusing on friendship and other important values in the healing relationship. Embracing medicine, philosophy, theology, and bioethics, it considers whether bioethical issues in medicine, nursing, and dentistry can be examined from the perspective of the healing relationship rather than external moral principles.

Distinguished contributors explore the role of the health professional, the moral basis of health care, greater emphasis on the humanities in medical education, and some of the current challenges facing healers today.

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Health, Luck, and Justice

Shlomi Segall

"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck.

Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state?

By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

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Hippocratic, Religious, and Secular Medical Ethics

The Points of Conflict

Robert M. Veatch

Where should physicians get their ethics? Professional codes such as the Hippocratic Oath claim moral authority for those in a particular field, yet according to medical ethicist Robert Veatch, these codes have little or nothing to do with how members of a guild should understand morality or make ethical decisions. While the Hippocratic Oath continues to be cited by a wide array of professional associations, scholars, and medical students, Veatch contends that the pledge is such an offensive code of ethics that it should be summarily excised from the profession. What, then, should serve as a basis for medical morality?

Building on his recent contribution to the prestigious Gifford Lectures, Veatch challenges the presumption that professional groups have the authority to declare codes of ethics for their members. To the contrary, he contends that role-specific duties must be derived from ethical norms having their foundations outside the profession, in religious and secular convictions. Further, these ethical norms must be comprehensible to lay people and patients. Veatch argues that there are some moral norms shared by most human beings that reflect a common morality, and ultimately it is these generally agreed-upon religious and secular ways of knowing—thus far best exemplified by the 2005 Universal Declaration on Bioethics and Human Rights—that should underpin the morality of all patient-professional relations in the field of medicine.

Hippocratic, Religious, and Secular Medical Ethics is the magnum opus of one of the most distinguished medical ethicists of his generation.

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