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Drawing from clinical experience, philosophy, psychology, and current health law and policy, Biomedical Ethics and Decision-Making is a detailed survey of persistent issues in health care ethics, emphasizing the complexities and nuances of practical decision-making and yielding a multifaceted and systematic approach to solving problems. As a useful resource for both students and clinicians, it includes references for further exploration of ethical issues as well as provocative questions for discussion in classroom and clinical settings. As a textbook, it stands alongside such standard works as Beauchamp's and Childress's Principles of Biomedical Ethics; DeGrazia's, Mappes's, and Ballard's Biomedical Ethics; Munson's Intervention and Reflection; and Vaughn's Bioethics. Besides presenting current dilemmas in health care, it reviews elements of cognitive psychology, describes common errors in critical thinking, offers techniques for evaluating and integrating evidence into ethical reasoning, assesses professionals and professionalism, invites readers to dissect philosophical analyses to bolster their critical thinking skills, and provides opportunities to engage in self-reflection on contemporary challenges in health care policy and delivery.
Biomedical Ethics for Engineers provides biomedical engineers with a new set of tools and an understanding that the application of ethical measures will seldom reach consensus even among fellow engineers and scientists. The solutions are never completely technical, so the engineer must continue to improve the means of incorporating a wide array of societal perspectives, without sacrificing sound science and good design principles.Dan Vallero understands that engineering is a profession that profoundly affects the quality of life from the subcellular and nano to the planetary scale. Protecting and enhancing life is the essence of ethics; thus every engineer and design professional needs a foundation in bioethics. In high-profile emerging fields such as nanotechnology, biotechnology and green engineering, public concerns and attitudes become especially crucial factors given the inherent uncertainties and high stakes involved. Ethics thus means more than a commitment to abide by professional norms of conduct. This book discusses the full suite of emerging biomedical and environmental issues that must be addressed by engineers and scientists within a global and societal context. In addition it gives technical professionals tools to recognize and address bioethical questions and illustrates that an understanding of the application of these measures will seldom reach consensus even among fellow engineers and scientists.· Working tool for biomedical engineers in the new age of technology· Numerous case studies to illustrate the direct application of ethical techniques and standards· Ancillary materials available online for easy integration into any academic program
The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases, Second Edition, explores fundamental ethical questions arising from real situations faced by health professionals, patients, and others. Featuring a wide range of more than 100 case studies drawn from current events, court cases, and physicians' experiences, the book is divided into three parts. Part 1 presents a basic framework for ethical decision-making in healthcare, while Part 2 explains the relevant ethical principles: beneficence and nonmaleficence, justice, respect for autonomy, veracity, fidelity, and avoidance of killing. Parts 1 and 2 provide students with the background to analyze the ethical dilemmas presented in Part 3, which features cases on a broad spectrum of issues including abortion, mental health, experimentation on humans, the right to refuse treatment, and much more. The volume is enhanced by opening text boxes in each chapter that cross-reference relevant cases in other chapters, an appendix of important ethical codes, and a glossary of key terms.
Patients today are more empowered and knowledgeable than they have ever been. By law, they must be told about the risks and benefits of proposed treatments and give informed consent before treatment is initiated. Through the democratization of medical information, they have access to peer-reviewed medical journals. Social media allows patients to share stories with others and to learn about other people's experiences with various treatments. There are websites written by experts at leading medical schools to help patients understand diseases and treatments. They have the right to see their medical records. The net result of all changes is a shift in the power balance between doctors and patients. Ideally, as a result of these shifts, the patients' values and preferences should guide treatment decisions. However, this proliferation of information often leads to confusion rather than clarity. Publicly available information often includes seemingly contradictory conclusions and recommendations. Patients don't know which opinions to trust. So, although patients have more information than ever, and many want to make decisions for themselves, they need more guidance than ever to help them process an avalanche of information. This volume aims to help both medical professionals and their patients navigate the evolving healthcare landscape by analyzing the process of shared decision-making (SDM) in clinical medicine. The concept of SDM has emerged in the last two decades as a middle ground between, on the one hand, old-fashinioned physician paternalism of the "doctor-knows-best" variety and, on the other hand, unfettered patient autonomy by which patients are thought capable of individually and independently choosing their own medical interventions. Advocates of SDM imagine that decisions will be made best if they follow a complex discussion and negotiation between doctor and patient; such discussions should incorporate the doctor's medical and technical expertise as well as the patient's goals, values, and preferences. SDM takes different forms for different patients in different clinical circumstances. This volume gathers experts in SDM to share their insights about how it ought to be done. The authors include clinicians, social scientist, and philosophers, all of whom have thought about or cared for patients from a variety of backgrounds and in a variety of clinical circumstances. The papers explore the complexity of SDM and offer practical guidance, gained from years of experience, about how to employ SDM as effectively as possible.
Breakthroughs in biomedicine often lead to new life-giving treatments but may also raise troubling, even life-and-death, quandaries. Society's Choices discusses ways for people to handle today's bioethics issues in the context of America's unique history and cultureâ€"and from the perspectives of various interest groups. The book explores how Americans have grappled with specific aspects of bioethics through commission deliberations, programs by organizations, and other mechanisms and identifies criteria for evaluating the outcomes of these efforts. The committee offers recommendations on the role of government and professional societies, the function of commissions and institutional review boards, and bioethics in health professional education and research. The volume includes a series of 12 superb background papers on public moral discourse, mechanisms for handling social and ethical dilemmas, and other specific areas of controversy by well-known experts Ronald Bayer, Martin Benjamin, Dan W. Brock, Baruch A. Brody, H. Alta Charo, Lawrence Gostin, Bradford H. Gray, Kathi E. Hanna, Elizabeth Heitman, Thomas Nagel, Steven Shapin, and Charles M. Swezey.
This book clarifies the meaning of the most important and pervasive concepts and tools in bioethical argumentation (principles, values, dignity, rights, duties, deliberation, prudence) and assesses the methodological suitability of the main methods for clinical decision-making and argumentation. The first part of the book is devoted to the most developed or promising approaches regarding bioethical argumentation, namely those based on principles, values and human rights. The authors then continue to deal with the contributions and shortcomings of these approaches and suggest further developments by means of substantive and procedural elements and concepts from practical philosophy, normative systems theory, theory of action, human rights and legal argumentation. Furthermore, new models of biomedical and health care decision-making, which overcome the aforementioned criticism and stress the relevance of the argumentative responsibility, are included.
Tough Decisions places readers in realistic composites of cases the authors have actually seen or managed where they must make tough medical decisions. What happens in them often depends on the reader's decisions and thus gives a sense of pressures that bear on clinical-decision making.
Medical practice is an inherently ethical enterprise. More than ever before, medical practice requires that medical professionals develop and exercise high ethical standards. Health care practitioners who ignore basic concepts of medical ethics risk exposing their patients to serious harm, and open themselves and their institutions to charges of malpractice. Clinical Bioethics provides for the busy clinical professional a concise, comprehensive treatment of the basics in this complex new field.
An analysis of how findings in behavioral economics challenge fundamental assumptions of medical ethics, integrating the latest research in both fields. Bioethicists have long argued for rational persuasion to help patients with medical decisions. But the findings of behavioral economics—popularized in Thaler and Sunstein’s Nudge and other books—show that arguments depending on rational thinking are unlikely to be successful and even that the idea of purely rational persuasion may be a fiction. In Good Ethics and Bad Choices, Jennifer Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She not only integrates the latest research from both fields but also provides examples of how physicians apply concepts of behavioral economics in practice. Blumenthal-Barby analyzes ethical issues raised by “nudging” patient decision making and argues that the practice can improve patient decisions, prevent harm, and perhaps enhance autonomy. She then offers a more detailed ethical analysis of further questions that arise, including whether nudging amounts to manipulation, to what extent and at what point these techniques should be used, when and how their use would be wrong, and whether transparency about their use is required. She provides a snapshot of nudging “in the weeds,” reporting on practices she observed in clinical settings including psychiatry, pediatric critical care, and oncology. Warning that there is no “single, simple account of the ethics of nudging,” Blumenthal-Barby offers a qualified defense, arguing that a nudge can be justified in part by the extent to which it makes patients better off.
​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.