Indiana University Press

Medical Ethics

Published by: Indiana University Press

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Medical Ethics

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Business Ethics in Healthcare

Beyond Compliance

Leonard J. Weber

Healthcare ethics is not just about decisions made at the bedside. It is also about decisions made in executive offices and in boardrooms. Business Ethics in Healthcare offers perspectives that can assist healthcare managers achieve the highest ethical standards as they face their roles as healthcare providers, employers, and community service organizations. Weber suggests guidelines and criteria based on the understanding that the healthcare organization is committed to patients' rights, to careful stewardship of resources, to just working conditions for employees, and to service to the community.

As Weber shows, addressing business ethics issues in a healthcare organization starts with complying with relevant laws and regulations. As a provider of high quality patient care with limited resources, it needs to be able to distinguish between the right way and the wrong way of taking cost into consideration when making decisions about patient care practices. As employer, the organization needs to use good criteria for determining wages and salaries, to know how to make fair decisions about downsizing, and to respond most appropriately to union organizing efforts and employee strikes. As a community service organization, it has particular responsibilities to the community in the way it advertises, how it disposes of medical waste, and the types of mergers it enters into.

Leonard J. Weber is on the faculty of the University of Detroit, Mercy. He has published over 70 articles and is the principal author of the "Case Studies in Ethics" column in Clinical Leadership & Management Review. He serves as an ethics consultant to several healthcare organizations and is a past president of the Medical Ethics Resource Network of Michigan.

Medical Ethics Series -- David H. Smith and Robert M. Veatch, editors

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Children, Ethics, and Modern Medicine

Richard B. Miller

"Because the discipline of medical ethics has developed with autonomy as its foundation, the field has ignored pediatric ethics. The book is resoundingly successful in its effort to rectify this problem.... [A] pleasure to read." -- Eric D. Kodish, M.D., Director, Rainbow Center for Pediatric Ethics, Case Western Reserve University

Using a form of medical ethnography to investigate a variety of pediatric contexts, Richard B. Miller tests the fit of different ethical approaches in various medical settings to arrive at a new paradigm for how best to care for children. Miller contends that the principle of beneficence must take priority over autonomy in the treatment of children. Yet what is best for the child is a decision that doctors cannot make alone. In making and implementing such decisions, Miller argues, doctors must become part of a "therapeutic alliance" with families and the child undergoing medical care to come up with the best solution.

Children, Ethics, and Modern Medicine combines strong philosophical argumentation with firsthand knowledge of the issues facing children and families in pediatric care. This book will be an invaluable asset to medical ethicists and practitioners in pediatric care, as well as parents struggling with ethical issues in the care of their children.

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No Place Like Home?

Feminist Ethics and Home Health Care

Jennifer A. Parks

"No Place Like Home? combines the rigorous scholarship of an academic feminist philosopher with the 'close to the ground' insights that come from bathing, feeding, and caring for older people as a home care aide. This book develops recent work in feminist philosophy that attends to both care and justice to propose a way to reform home care to reduce its exploitative qualities while assuring that it is more than 'bed and body' work." -- Martha B. Holstein, Visiting Scholar, Center for Research on Women and Gender at the University of Illinois, Chicago and co-editor, Ethics and Community Based Elder Care

"For a scathing critique of how American society abuses both those who receive home-based care as well as those who provide it, and a sophisticated vision of how we might move toward a more just future, there's no book like No Place Like Home?." -- James Lindemann Nelson, co-author of Alzheimer's: Answers to Hard Questions for Families

"[Jennifer Parks's] critique of current practices and institutions is thorough and accurate, benefiting both from her own experience as a homecare worker and the philosophically sophisticated tools she brings to bear on it." -- Laura Purdy, Professor of Philosophy, Wells College

In this provocative new book, Jennifer A. Parks analyzes practices in the home health care industry and concludes that they are highly exploitative of both workers and patients. Under the existing system, underpaid workers are expected to perform tasks for which they are inadequately trained, in unreasonably short periods of time. This situation, Parks argues, harms workers and puts home health care patients at risk. To the extent that the majority of patients and workers in home health care are women, she turns to feminist ethics for an alternative approach. Through an understanding of individuals as social beings with obligations to others, and of home health care as a public good, Parks explains how to develop the social benefits of good home health care and increase the role of government in providing financial support and regulatory oversight.

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Wondergenes

Genetic Enhancement and the Future of Society

Maxwell J. Mehlman

Wondergenes not only imagines a future world in which genetic enhancement is the norm, but asserts that this future has already begun. Genetically engineered substances are already in use by athletes, in vitro fertilization already provides the primitive means by which parents can "select" an embryo, and the ability to create new forms of genetically engineered human beings is not far off. What happens when gene therapy becomes gene enhancement? Who will benefit and who might be left behind? What are the costs to our values and beliefs, and to the future of our society? To answer these questions, Maxwell J. Mehlman provides an overview of the scientific advances that have led to the present state of genetic enhancement and explains how these advances will be used in the future to redefine what we think of as a normal human being. He explores the ethical dilemmas already facing researchers and medical practitioners, and the dilemmas we will all be expected to face. In his forecast of the dangers inherent in this technology, he is particularly concerned with the emergence of a "genobility" made up of those able to afford increasingly expensive enhancement.

Wondergenes is a serious, accessible introduction to the social and personal implications of genetic engineering. Mehlman weighs the social and economic costs of the many proposals to regulate or limit genetic engineering and provides six concrete policy recommendations -- from professional licensing to a ban on germ-line enhancement -- that propose to make the future of genetic enhancement more equitable and safe.

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