How much should the patient be told? How strongly should he be urged to plan for his own future? Is it ever right to lie to the patient about her condition? When is it right to place your loved one in a nursing home--and not feel guilty about it? How do different family members arrive at agreement among themselves in each of these situations?
Authors and bioethicists James and Hilde Lindemann Nelson have written an invaluable step-by-step guide to tackling these and other difficult decisions. Using their extensive research on moral issues in health care, the Nelsons create hypothetical scenarios that demonstrate some of the most common situations caregivers will have to face during every stage of the illness, and show by example how they can make the right choices for themselves, the patient, and the rest of the family. This invaluable information, combined with a state-by-state and city-by-city guide to agencies and support groups offering practical assistance, as well as a list of suggested reading on the subject, make this book unique--and the most complete source of advice available.
Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.
The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.
At twelve, Howard Dully was guilty of the same crimes as other boys his age: he was moody and messy, rambunctious with his brothers, contrary just to prove a point, and perpetually at odds with his parents. Yet somehow, this normal boy became one of the youngest people on whom Dr. Walter Freeman performed his barbaric transorbital—or ice pick—lobotomy.
Abandoned by his family within a year of the surgery, Howard spent his teen years in mental institutions, his twenties in jail, and his thirties in a bottle. It wasn’t until he was in his forties that Howard began to pull his life together. But even as he began to live the “normal” life he had been denied, Howard struggled with one question: Why?
There were only three people who would know the truth: Freeman, the man who performed the procedure; Lou, his cold and demanding stepmother who brought Howard to the doctor’s attention; and his father, Rodney. Of the three, only Rodney, the man who hadn’t intervened on his son’s behalf, was still living. Time was running out. Stable and happy for the first time in decades, Howard began to search for answers.Through his research, Howard met other lobotomy patients and their families, talked with one of Freeman’s sons about his father’s controversial life’s work, and confronted Rodney about his complicity. And, in the archive where the doctor’s files are stored, he finally came face to face with the truth.
Revealing what happened to a child no one—not his father, not the medical community, not the state—was willing to protect, My Lobotomy exposes a shameful chapter in the history of the treatment of mental illness. Yet, ultimately, this is a powerful and moving chronicle of the life of one man.
No substance on earth is as hotly debated as marijuana. Opponents claim it’s dangerous, addictive, carcinogenic, and a gateway to serious drug abuse. Fans claim it as a wonder drug, treating cancer, anorexia, AIDS, chronic pain, glaucoma, arthritis, migraines, PTSD, and insomnia. Patients suffering from these conditions need—and deserve—hard facts based on medical evidence, not hysteria and superstition.
In Stoned, palliative care physician Dr. David Casarett sets out to do anything—including experimenting on himself—to find evidence of marijuana’s medical potential. He smears mysterious marijuana paste on his legs and samples pot wine. He poses as a patient at a seedy California clinic and takes lessons from an artisanal hash maker. In conversations with researchers, doctors, and patients around the world he learns how marijuana works—and doesn’t—in the real world.
Dr. Casarett unearths tales of near-miraculous success, such as a child with chronic seizures who finally found relief in cannabidiol oil. In Tel Aviv, he learns of a nursing home that’s found success giving marijuana to dementia patients. On the other hand, one patient who believed marijuana cured her lung cancer has clearly been misled. As Casarett sifts the myth and misinformation from the scientific evidence, he explains, among other things:
• Why marijuana might be the best treatment option for some types of pain
• Why there’s no significant risk of lung damage from smoking pot
• Why most marijuana-infused beer or wine won’t get you high
Often humorous, occasionally heartbreaking, and full of counterintuitive conclusions, Stoned offers a compassionate and much-needed medical practitioner’s perspective on the potential of this misunderstood plant.
All these problems have been shielded from public scrutiny because they're too complex to capture in a sound bite. But Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct in the medical industry affects us on a global scale.
With Goldacre's characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for regulation. This is the pharmaceutical industry as it has never been seen before.
How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. Rationing Sanity integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care—the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill—but also how we may find more just and humane treatment for those afflicted.
Now in its fifth edition, Caring for Patients from Different Cultures covers a wide range of topics, including birth, end of life, communication, traditional medicine, mental health, pain, religion, and multicultural staff challenges. This edition includes more than sixty new cases with an expanded appendix, introduces a new chapter on improving adherence, and updates the concluding chapter with examples of changes various hospitals have made to accommodate cultural differences. Grounded in concepts from the fields of cultural diversity and medical anthropology, Caring for Patients from Different Cultures provides healthcare workers with a frame of reference for understanding cultural differences and sound alternatives for providing the best possible care to multicultural communities.
A haunting, deeply compassionate book—now revised with a new introduction—Mad in America raises important questions about our obligations to the mad, the meaning of “insanity,” and what we value most about the human mind.
Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known—Gilda Radner's battle with ovarian cancer—to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilities. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic.
In this new edition Frank adds a preface describing the personal and cultural times when the first edition was written. His new afterword extends the book’s argument significantly, writing about storytelling and experience, other modes of illness narration, and a version of hope that is both realistic and aspirational. Reflecting on both his own life during the creation of the first edition and the conclusions of the book itself, Frank reminds us of the power of storytelling as way to understanding our own suffering.
No one could believe that the handsome young doctor might be a serial killer. Wherever he was hired—in Ohio, Illinois, New York, South Dakota—Michael Swango at first seemed the model physician. Then his patients began dying under suspicious circumstances.
At once a gripping read and a hard-hitting look at the inner workings of the American medical system, Blind Eye describes a professional hierarchy where doctors repeatedly accept the word of fellow physicians over that of nurses, hospital employees, and patients—even as horrible truths begin to emerge. With the prodigious investigative reporting that has defined his Pulitzer Prize–winning career, James B. Stewart has tracked down survivors, relatives of victims, and shaken coworkers to unearth the evidence that may finally lead to Swango’s conviction.
Combining meticulous research with spellbinding prose, Stewart has written a shocking chronicle of a psychopathic doctor and of the medical establishment that chose to turn a blind eye on his criminal activities.
New sections added in this revised fourth edition include sequencing whole genomes, even those of newborns; the new developments in genetic testing now provided by online commercial companies such as 23andMe; the genetic testing of fetuses by capturing their DNA circulating in the pregnant woman's blood; the Stanford Prison experiment and its relevance to the abuses at the Abu Graib prison; recent breakthroughs in the diagnosis of consciousness disorders such as PVS; the ongoing controversy generated by the NIH study of premature babies at many NICUs throughout the county, a study known as SUPPORT that the OHRP (Office of Human Research Protections, an office within the department of HHS) deemed unethical.
Devettere updates most chapters. New cases include Marlise Munoz (dead pregnant woman's body kept on life support by a Texas hospital), Jahi McMath (teenager pronounced dead in California but treated as alive in New Jersey), Margot Bentley (nursing home feeding a woman dying of end stage Alzheimer’s despite her advance directive that said no nourishment or liquids if she was dying with dementia), Brittany Maynard (dying 29-year-old California woman who moved to Oregon to commit suicide with a physician's help), and Samantha Burton (woman with two children who suffered rupture of membranes at 25 weeks and whose physician obtained a court order to keep her at the hospital to make sure she stayed on bed rest). Thoughtfully updated and renewed for a new generation of readers, this classic textbook will be required reading for students and scholars of philosophy and medical ethics.
"... a fascinating dissection of almost every aspect of the doctor-patient relationship.... strongly recommended reading for all health care workers interested in this rapidly evolving field."Â -- Queen's Quarterly
"This outstanding discussion of important current medical issues is a valuable addition to academic and professional libraries." -- Choice
"... an important contribution to bioethics... certain to provoke controversy in the field."Â -- Medical Humanities Review
"Lucid and well-argued... " -- Religious Studies Review
This book heralds the imminent demise of "doctor knows best." In it, Robert M. Veatch proposes a postmodern medicine in which decisions about patient care will routinely involve both doctor and patient -- not only in ethically complex cases such as the termination of life-sustaining treatment, but in everyday care as well.
The narratives Richard Zaner shares in Conversations on the Edge are informed by his depth of knowledge in medicine and bioethics, but are never "clinical." A genuine and caring heart beats underneath his compassionate words. Zaner has written several books in which he tells poignant stories of patients and families he has encountered; there is no question that this is his finest.
In Conversations on the Edge, Zaner reveals an authentic empathy that never borders on the sentimental. Among others, he discusses Tom, a dialysis patient who finally reveals that his inability to work—encouraged by his overprotective mother—is the source of his hostility to treatment; Jim and Sue, young parents who must face the nightmare of letting go of their premature twins, one after the other; Mrs. Oland, whose family refuses to recognize her calm acceptance of her own death; and, in the final chapter, the author's mother, whose slow demise continues to haunt Zaner's professional and personal life.
These stories are filled with pain and joy, loneliness and hope. They are about life and death, about what happens in hospital rooms—and that place at the edge—when we confront mortality. It is the rarest of glimpses into the world of patients, their families, healers, and those who struggle, like Zaner, to understand.
The rapid pace of emerging technologies is playing an increasingly important role in overcoming fundamental human limitations. Featuring core writings by seminal thinkers in the speculative possibilities of the posthuman condition, essays address key philosophical arguments for and against human enhancement, explore the inevitability of life extension, and consider possible solutions to the growing issues of social and ethical implications and concerns. Edited by the internationally acclaimed founders of the philosophy and social movement of transhumanism, The Transhumanist Reader is an indispensable guide to our current state of knowledge of the quest to expand the frontiers of human nature.
This thoroughly revised second edition provides a concise, readable and authoritative introduction for anyone interested in the study of bioethics.
Physician and philosopher Daniel Sulmasy is uniquely qualified to guide readers through this terrain. At the outset of this accessible, engaging volume, he explores the nature of illness and healing, focusing on health care's rich history as a spiritual practice and on the human dignity of the patient. Combining sound theological reflection with doses of healthy skepticism, he goes on to describe empirical research on the effects of spirituality on health, including scientific studies of the healing power of prayer, emphasizing that there are reasons beyond even promising research data to attend to the souls of patients. Finally, Sulmasy devotes special attention and compassion to the care of people at the end of life, incorporating the stories of several of his patients.
Throughout, the author never strays from the theme that, for physicians, attending to the spiritual needs of patients should not be a moral option, but a moral obligation. This book is an essential resource for scholars and students of medicine and medical ethics and especially medical students and health care professionals.
For readers of Atul Gawande and Jerome Groopman, a book of beautifully crafted stories about what life is like for patients kept alive by modern medical technology.
Modern medicine is a world that glimmers with new technology and cutting-edge research. To the public eye, medical stories often begin with sirens and flashing lights and culminate in survival or death. But these are only the most visible narratives. As a critical care doctor treating people at their sickest, Daniela Lamas is fascinated by a different story: what comes after for those whose lives are extended by days, months, or years as a result of our treatments and technologies?
In You Can Stop Humming Now, Lamas explores the complex answers to this question through intimate accounts of patients and their families. A grandfather whose failing heart has been replaced by a battery-operated pump; a salesman who found himself a kidney donor on social media; a college student who survived a near fatal overdose and returned home, alive but not the same; and a young woman navigating an adulthood she never thought she'd live to see -- these moving narratives paint a detailed picture of the fragile border between sickness and health.
Riveting, gorgeously told, and deeply personal, You Can Stop Humming Now is a compassionate, uncompromising look at the choices and realities that many of us, and our families, may one day face.
Built around engaging case studies from news media, court hearings, famous speeches and philosophical writings, each of the 15 chapters:
- explains and defines the moral problem dealt with
- provides excerpts of readings on all sides of the issue
- analyses the problem, using the relevant theory
The examples are recognizable ethical problems, including judgments about racism and sexism, controversial debates such as assisted suicide and the death penalty, and contemporary concerns like privacy and technology, corporate responsibility, and the environment.
The mission of the book is to assist you to engage in informed, independent, critical thinking and to enable you to enter into ethical discussions in the classroom and beyond. Supported by learning features, including study questions, key quotes, handy definitions and a companion website, this book is essential for any student of moral philosophy.
Did you know...
- !--[endif]--Medical interventions have become the third leading cause of death in America.
- !--[endif]--An estimated 10 percent of Americans are implanted with medical devices -- like pacemakers, artificial hips, cardiac stents, etc.
- !--[endif]--The overwhelming majority of high-risk implanted devices have never undergone a single clinical trial.
In THE DANGER WITHIN US, award-winning journalist Jeanne Lenzer brings these horrifying statistics to life through the story of one working class man who, after his "cure" nearly kills him, ends up in a battle for justice against the medical establishment.
His crusade leads Lenzer on a journey through the dark underbelly of the medical device industry, a fascinating and disturbing world that hasn't been written about before. What Lenzer exposes will shock readers: rampant corruption, elaborate cover-ups, shameless profiteering, and astonishing lack of oversight, all of which leads to dangerous devices (from artificial hips to pacemakers) going to market and into our bodies.
In the vein of America's Bitter Pill and A Civil Action, THE DANGER WITHIN US is a stirring call for reform and a must-read for anyone who cares about the future of American healthcare. span
In recent years, there have been major outbreaks of whooping cough among children in California, mumps in New York, and measles in Ohio's Amish country—despite the fact that these are all vaccine-preventable diseases. Although America is the most medically advanced place in the world, many people disregard modern medicine in favor of using their faith to fight life threatening illnesses. Christian Scientists pray for healing instead of going to the doctor, Jehovah's Witnesses refuse blood transfusions, and ultra-Orthodox Jewish mohels spread herpes by using a primitive ritual to clean the wound. Tragically, children suffer and die every year from treatable diseases, and in most states it is legal for parents to deny their children care for religious reasons. In twenty-first century America, how could this be happening?
In Bad Faith, acclaimed physician and author Dr. Paul Offit gives readers a never-before-seen look into the minds of those who choose to medically martyr themselves, or their children, in the name of religion. Offit chronicles the stories of these faithful and their children, whose devastating experiences highlight the tangled relationship between religion and medicine in America. Religious or not, this issue reaches everyone—whether you are seeking treatment at a Catholic hospital or trying to keep your kids safe from diseases spread by their unvaccinated peers.
Replete with vivid storytelling and complex, compelling characters, Bad Faith makes a strenuous case that denying medicine to children in the name of religion isn't just unwise and immoral, but a rejection of the very best aspects of what belief itself has to offer.
The social, legal and professional regulation context is brought into the discussion throughout, to equip students with the knowledge that they need to make clinical decisions.
Topics covered include:
- Beauchamp and Childress' four principles of bioethics
- Personal and individual conscience
- Moral philosophy
- The virtues/virtue ethics of the practitioner.
This book will be essential reading for pre-registration nursing students taking modules in ethics and law. It will also be a valuable text for postgraduates and qualified nurses, and students of health who need to gain an appreciation of ethics.
Historically one can see that health, disease, and illness are concepts that have been ever fluid. Modern science, sociology, philosophy, even society—among other factors—constantly have these issues under microscopes, learning more, defining and redefining ever more exactly. Yet often that scrutiny, instead of leading toward hard answers, only leads to more questions. Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine.
Divided into four parts—Historical Discussions; Characterizing Health, Disease, and Illness; Clinical Applications of Health and Disease; and Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease—the reader can see the evolutionary arc of medical concepts from the Greek physician Galen of Pergamum (ca. 150 ce) who proposed that "the best doctor is also a philosopher," to contemporary discussions of the genome and morality. The editors have recognized a crucial need for a deeper integration of medicine and philosophy with each other, particularly in an age of dynamically changing medical science—and what it means, medically, philosophically, to be human.
Ethical challenges often arise from the unanticipated consequences of a research design, from conflicts among stakeholders, or from the clash of two positive ethical principleswhen adherence to one of the principles may violate another. Functioning both as a capstone and a learning tool, the last chapter presents a real-life ethical dilemma and introduces readers to a detailed problem-solving guide. Other pedagogical aids include end-of-chapter questions that inspire deeper thinking about ethical principles and issues, and five brief ethical dilemma cases for further enrichment and study.
This edited volume gathers articles, contemporary newspaper accounts, selections from reports and letters, reconsiderations of the study by many of its principal actors, and works of fiction, drama, and poetry to tell the Tuskegee story as never before. Together, these pieces illuminate the ethical issues at play from a remarkable breadth of perspectives and offer an unparalleled look at how the study has been understood over time.
In medical school, no one teaches you how to let a patient die.
Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice.
Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully.
Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.
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.-- Kenneth Prager, Columbia University Medical Center
Structured like a legal casebook, Law and Bioethics includes the text of almost all the landmark cases that have shaped bioethics. Jerry Menikoff offers commentary on each of these cases, as well as a lucid introduction to the U.S. legal system, explaining federalism and underlying common law concepts. Students and professionals in medicine and public health, as well as specialists in bioethics, will find the book a valuable resource.
As the debate grows in urgency, how should theology respond? Christian theologians recognize truth on both sides of the argument, pointing out how the yearnings of the transhumanists—if not their technological methods—find deep affinities in Christian belief. In this volume, Ronald Cole-Turner has joined seasoned scholars and younger, emerging voices together to bring fresh insight into the technologies that are already reshaping the future of Christian life and hope.
This thoroughly revised and updated second edition includes thirteen new cases, five of which are designated as "skill builder" cases aimed specifically at persons who wish to conduct clinical ethics case consultations. The new cases highlight current ethical challenges that arise in caring for populations such as undocumented immigrant patients, persons with substance use disorders involving opioids, and ethical issues that arise beyond the bedside at the organizational level. The reader is invited to use the supplemental videos and assessment tools available on the website of the Loyola University Chicago ACES project (www.LUC.edu/ethicsconsult).
American taxpayers spend $30 billion annually funding biomedical research, but over half of these studies can't be replicated due to poor experimental design, improper methods, and sloppy statistics. Bad science doesn't just hold back medical progress, it can sign the equivalent of a death sentence for terminal patients. In Rigor Mortis, Richard Harris explores these urgent issues with vivid anecdotes, personal stories, and interviews with the top biomedical researchers. We need to fix our dysfunctional biomedical system--before it's too late.
Written in an engaging, debate-style format for accessibility to non-specialists Features general introductions to each topic that precede scholarly debates Presents the latest, cutting-edge thoughts on relevant bioethics ideas, arguments, and debates
Thoroughly updated and expanded, this edition includes chapters addressing the unique challenges facing children with HIV/AIDS and their families, care in home and ICU settings, difficult decision-making processes, and the importance of communication with the child and family, as well as completely new chapters on spiritual dimensions of care and educational and advocacy initiatives. Intended for primary care physicians, pediatric practitioners and specialists, home care and hospice personnel, pastoral counselors, and affected families, the book includes useful resource and reference material and practical, hands-on tips.
With contributions from an international group of expert educators, clinicians, and parents, this book takes a truly interdisciplinary approach to pediatric palliative care, presenting best practices, clear instruction, and the latest information and research for anyone involved in pediatric palliative and end-of-life care.