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This book is a critical examination of certain basic issues and themes crucial to understanding how ethics currently interfaces with health care and biomedical research. Beginning with an overview of the field, it proceeds through a delineation of such key notions as trust and uncertainty, dialogue involving talk and listening, the vulnerability of the patient against the asymmetric power of the health professional, along with professional and individual responsibility. It emphasizes several themes fundamental to ethics and health care: (1) the work of ethics requires strict focus on the specific situational understanding of each involved person. (2) Moral issues, at least those intrinsic to each clinical encounter, are presented solely within the contexts of their actual occurrence; therefore, ethics must not only be practical but empirical in its approach. (3) Each particular situation is in its own way imprecise and uncertain and the different types and dimensions of imprecision and uncertainty are critical for everyone involved. (4) Finally, medicine and health care more broadly are governed by the effort to make sense of the healer’s experiences with the patient, whose own experiences and interpretations are ingredient to what the healer seeks to understand and eventually treat. In addition to providing a way to develop ethical considerations in clinical life and research projects, the book proposes that narratives provide the finest way to state and grapple with these themes and issues, whether in classrooms or real-life situations. It concludes with a prospective analysis of newly emerging issues presented by and within the new genetics, which, together within a focus on the phenomenon of birth, leads to an clearer understanding of human life.
Clinical Ethics introduces the four-topics method of approaching ethical problems (i.e., medical indications, patient preferences, quality of life, and contextual features). Each of the four chapters represents one of the topics. In each chapter, the authors discuss cases and provide comments and recommendations. The four-topics method is an organizational process by which clinicians can begin to understand the complexities involved in ethical cases and can proceed to find a solution for each case.
Examines the many ethical issues related to biomedical research, including the use of animals in research, research on human subjects, clinical trials, international research ethics policies, and other related topics.
On February 26, 2020, the Board on Health Sciences Policy of the National Academies of Sciences, Engineering, and Medicine hosted a 1-day public workshop in Washington, DC, to examine current and emerging bioethical issues that might arise in the context of biomedical research and to consider research topics in bioethics that could benefit from further attention. The scope of bioethical issues in research is broad, but this workshop focused on issues related to the development and use of digital technologies, artificial intelligence, and machine learning in research and clinical practice; issues emerging as nontraditional approaches to health research become more widespread; the role of bioethics in addressing racial and structural inequalities in health; and enhancing the capacity and diversity of the bioethics workforce. This publication summarizes the presentations and discussions from the workshop.
​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.
This book compares and contrasts ethical and policy issues in healthcare from countries around the globe, and illustrates how theory can and should inform practice.
Over the last several decades, bioethicists have championed a bewildering variety of methods for understanding and resolving difficult ethical problems in medicine, including: principlism, wide reflective equilibrium, casuistry, feminism, virtue theory, narrative, and others. Much of this advocacy overlooks the limitations of the favored method, and also neglects the strengths found in alternative approaches. Tom Tomlinson systematically uncovers and evaluates both the strengths and limits of a variety of ethical tools, and in so doing develops a comprehensive appreciation of the roles that various methods can play in deepening our understanding of ethical problems in medicine, and in supporting well-grounded judgments about what to do. He critically evaluates each method to identify both limits and advantages, which he then illustrates through discussion of specific cases and controversies. Tomlinson not only demonstrates that there is no single method adequate to the task, but tries to develop an informed eclecticism that knows how to pick the right tool for the right job. All those engaged in thinking about bioethical theories will find Tomlinson's work important reading.
Based on extensive observations, interviews, and archival research, this book provides an in-depth insight into one of the most crucial forms of regulation around medical research: Research Ethics Committees. Every month, groups of people from all over the United Kingdom decide what kind of research should be carried out on patients within the National Health Service. These groups – Research Ethics Committees (RECs) – made up of doctors, nurses, researchers, and members of the general public – help shape the future of medicine, and play a crucial role in the regulation of a wide range of research from social science to epidemiology, vaccine and drugs trials, and surgery. In providing one of the first empirical examinations of this kind of regulation, this book highlights how, despite the trappings of a modern regulatory system, REC decision making revolves around outdated aspects of social life. Hedgecoe argues that an accurate understanding of this kind of regulation requires an acceptance of the inherently social nature of the processes involved. In placing trust at the centre of ethics decision making, this book challenges the impersonal, de-socialised, and mechanical models of REC decision making that dominate mainstream accounts, and documents the subtle, messy, and complex way in which these bodies decide what kind of research should take place.