Customer Reviews:
Great for entry level bioethics class.......2006-08-28
This is well written and concise...I choose it for the Bioethics class I will be teaching in Jan 07.
Author knows what he is talking about!
Circular Arguments of the Topic of Bioethics.......2000-07-23
This book briefly covers many topics relating to bioethics in a manner in which it can be used as a textbook or a book for informational enjoyment. The best aspect of the book is its medical cases; these give real-life examples of the topics discussed so that the arguments and rationale are not so confusing. As a college student, I found it very helpful because it covered a broad range of ethical topics, including abortion, euthanasia, etc.
Although the book was informative, the arguments were sometimes unclear. I understand that bioethics is a field of endless circular arguments, but the manner in which the topics were presented was sometimes difficult to understand. Some case examples were used but I think more would have been quite helpful. Whollly, the book served its purpose for me as being an introduction to bioethics, and it includes glossaries after every chapter to look up terms used in the text.
Book Description
Although managed health care is a hot topic, too few discussions focus on health care rationing -- who lives and who dies, death versus dollars. In this book, physician and bioethicist Peter A. Ubel argues that physicians, health insurance companies, managed care organizations, and governments need to consider the cost-effectiveness of many new health care technologies. In particular, they need to think about how best to ration health care. Ubel believes that standard medical training should provide physicians with the expertise to decide when to withhold health care from patients. He discusses the moral questions raised by this position, and by health care rationing in general. He incorporates ethical arguments about the appropriate role of cost-effectiveness analysis in health care rationing, empirical research about how the general public wants to ration care, and clinical insights based on his practice of general internal medicine. Straddling the fields of ethics, economics, research psychology, and clinical medicine, he moves the debate forward from whether to ration to how to ration. The discussion is enlivened by actual case studies.
Customer Reviews:
Solid Analysis of Issues Related to Health Care Rationing.......2000-06-11
Modern medicine is one of the great successes of industrial civilization. This remarkable progress, however, has come at a very high price. In the USA, for example, we spend close to 15% of our GNP on health care. We are the champion health care spendthrift of developed world but other industrialized countries spend huge amounts on health care. It is not surprising that huge pressures are exerted to hold down costs; HMO management in the USA, waiting lists for complex procedures in many countries; restricted access to specialists in Great Britain. All of these cost containment involve rationing of health care services. It is a surprise, then, that this good book is one of the few to explicitly address rationing of health care. Dr. Ubel makes a series of cogent, indeed, commonsense points. Rationing is common. Rationing is inevitable in any system without infinite resources. Physicians, even those who believe that they are not rationing health care, either practice rationing at the bedside and are enmeshed in systems that make rationing decisions. Ubel decries properly the existence of this type of implicit rationing and argues instead that since rationing is inevitable, physicians should participate in explicit and rational efforts to ration care. This leads Ubel to a series of interesting recommendations. One is that physicians are in the best position to make certain kinds of rationing decisions, "bedside rationing', because they can individualize care and are best able to attempt to reconcile the needs of patients with the existence of limited resources. Ubel is an advocate of a certain type of utilitarian analysis, cost effective analysis (CEA), as a tool for deciding the value of tests and interventions. He exposes the limitations of CEA carefully and suggests ways in which it might be improved in order to become a useful tool. I think this book is primarily aimed at academic physicians with the hope of influencing physician education and approach to this kind of difficult problem. In this respect, this is a successful effort.
There are several problems with the book. As Ubel acknowledges, it is not a rigorous or systematic book, but more polemical in spirit. There is definitely a need for a major systematic work(s) on this topic. Another problem is Ubel's recommendation of CEA. He is very clear about the limitations of this method but he recommends it because he views it as flexible enough to incorporate societal preferences. Even if this were methodologically possible, I doubt this would work in the USA. In relatively homogeneous and consensus oriented countries like Sweden or Japan, this approach would have real value. It has, however, been a long time since Americans reached consensus on many, many fundamental issues related to values, and this situation is unlikely to change. Finally, Ubel does not go far enough. Given resource limitations, methods like CEA,which help make choices among tests and interventions, will not address the really tough issues regarding who should receive care and how much is appropriate. These are horribly difficult problems but must be faced squarely.
Important information.......2000-05-23
Dr. Peter Ubel has written and important and useful book. He describes very clearly how medical care in the U.S. is already being rationed--even though we might not call it 'rationing,' or even realize it. He gives clear examples of how that process is being taken place; the arguments for and against it; and a very coherent argument that medical rationing will continue, and grow, because it is economically inevitable.
This book is important because it tells the reader that rationing will take place--with or without an informed patient role. It is up to those who receive medical care to understand what's at stake to make sure they do play an active part in the decision-making process.
The book is very clearly written, but more examples, particularly in the latter part of the book, would make is more readable.
Book Description
Is medical ethics in times of armed conflict identical to medical ethics in times of peace, as the World Medical Association declares? In Bioethics and Armed Conflict, the first comprehensive study of medical ethics in conventional, unconventional, and low-intensity war, Michael Gross examines the dilemmas that arise when bioethical principles clash with military necessity--when physicians try to save lives during an endeavor dedicated to taking them--and describes both the conflicts and congruencies of military and medical ethics.
Gross describes how the principles of contemporary just war, unlike those of medical ethics, often go beyond the welfare of the individual to consider the collective interests of combatants and noncombatants and the general interests of the state. Military necessity plays havoc with such patients' rights as the right to life, the right to medical care, informed consent, confidentiality, and the right to die. The principles of triage in battle conditions dictate not need-based treatment but the distribution of resources that will return the greatest number of soldiers to active duty. And unconventional warfare, including current "wars" on terrorism, challenges the traditional concept of medical neutrality as physicians who have sworn to "do no harm" are called upon to lend their expertise to "interrogational" torture or to the development of biological or chemical weapons. Difficult dilemmas inevitably arise during armed conflict, and medicine, Gross concludes, is not above the fray. Medical ethics in time of war cannot be identical to medical ethics in peacetime.
Customer Reviews:
Bioethics and Armed Conflict.......2007-05-06
In 2004, the World Medical Association declared that "medical ethics in times of armed conflict is identical to medical ethics in times of peace." Gross, an ethicist at the University of Haifa, takes issue with this conclusion. "Military personnel do not enjoy a right to life, personal autonomy, or a right to self-determination to any degree approaching that of ordinary patients," he observes. While bioethics focuses on the rights of an individual, military necessity places paramount authority in the state.
Many bioethicists, insulated by peace, wallow in theory and philosophy. Living in Israel - in Haifa, at that - and facing war, Gross infuses his study with reality. As commentators and human rights activists criticize U.S. participation in Iraq and Israeli actions, Gross examines a number of bioethical quandaries that have consequences for contemporary militaries and physicians. He offers rich historical background.
While doctors pledge to do no harm, war creates dilemmas. Is it right for surgeons to operate in order to enable soldiers to return to harm's way? The Geneva Conventions imply triage to be based upon the principle of need, but the North Atlantic Treaty Organization (NATO) prioritizes triage by ability to salvage soldiers. More broadly, Gross examines whether policymakers have an obligation to always preserve soldiers' lives or whether soldiers forfeit a right to life when they enlist. Can policymakers sacrifice soldiers or order them to take extreme risks? He also explores ethical dilemmas of resource allocation in cases where having more doctors means skimping on essential non-medical equipment.
For Middle East specialists, Gross's treatment of asymmetric warfare and the distinctions between combatants and noncombatants is a must-read. He illustrates theoretical discussions with examples drawn from the Iran-Iraq war and the Arab-Israeli conflict. For example, how should armies balance the need to protect medical facilities in combat zones when Palestinian terrorists use them as firing bases? What obligations is Israel under to allow medical access to besieged cities when terrorists ferry weapons and personnel in U.N. ambulances?
Gross also addresses issues such as the role of medical professionals in interrogations and ethical dilemmas posed by torture. With real-world examples, he explores the ethics behind the "ticking bomb scenario" when rigorous interrogation has prevented attacks by Palestinian terrorists. Also interesting is his discussion of the ethics of non-lethal chemical or biological weapons. Can doctors participate in studies that determine the greatest non-lethal level of incapacitation enemy soldiers can endure in the course of battle? What if such weapons affect civilians in urban combat?
The real value of Gross's book, though, is that he neither preaches nor resorts to demolishing straw-man arguments but rather seeks to outline contrasting arguments fairly. He discusses preexisting academic theories but does so without excessive jargon, making his book accessible to a wide audience. As such, Bioethics and Armed Conflict becomes an invaluable manual addressing some of the ethical issues of the day, useful not only for Middle Eastern specialists and military commanders but also for physicians and the general reader.
Michael Rubin
Middle East Quarterly
Summer 2007
Book Description
Human embryonic stem cells can divide indefinitely and have the potential to develop into many types of tissue. Research on these cells is essential to one of the most intriguing medical frontiers, regenerative medicine. It also raises a host of difficult ethical issues and has sparked great public interest and controversy.
This book offers a foundation for thinking about the many issues involved in human embryonic stem cell research. It considers questions about the nature of human life, the limits of intervention into human cells and tissues, and the meaning of our corporeal existence. The fact that stem cells may be derived from living embryos that are destroyed in the process or from aborted fetuses ties the discussion of stem cell research to the ongoing debates on abortion. In addition to these issues, the essays in the book touch on broader questions such as who should approve controversial research and what constitutes human dignity, respect, and justice. The book contains contributions from the Ethics Advisory Board of the Geron Coroporation; excerpts from expert testimony given before the National Bioethics Advisory Commission, which helped shape recent National Institutes of Health policy; and original analytical essays on the implications of this research.
Customer Reviews:
Bought for a class, but pretty interesting.......2006-03-17
I bought this book for a class, but it's pretty interesting anyway. The Catholic viewpoints in here are a bit... unrepresentative, though. The Jewish viewpoints were very enlightening.
It's a start, but where's the debate?.......2002-01-04
Holland et al. created a good introduction to the public policy and science behind the current embryonic stem cell research (ESCR) debate, but while this book has "debate" in its title, there was little material disagreement between most of the contributors. A more robust, representative exchange of ideas would have made this book 5-star material.
The book is divided into several themes.The first three chapters are on the basic science and history of stem cell research, and the editors' choice of contributors is impeccable: they include James Thomson, who first isolated human embryonic stem cells, and Thomas Okarma, president and CEO of Geron Corp., which is the private firm that has spearheaded the development of Thomson's discoveries.
The second section segues from history to public policy and ethics, including analyses of the National Bioethics Advisory Committee's report on stem cells in 1999. This by and large was a good introduction to how the government, and specifically the Clinton administration, began to respond to stem cells. Erik Parens has a good article on how people tried to differentiate between the morality of experimenting on embryos from IVF clinics and embryos made specifically for research, and a few other dilemmas stemming from current human embryonic stem cell (hES) sources and protocols.
We then go into the third section, which contains religious perspectives on ESCR. This is where I found the term "debate" a misnomer, as for the exception of Gilbert Meilaender, a Protestant thelogian, all the religious commentators tried to show how their traditions could tolerate, if not actively approve of, ESCR. Now I know that many religious people approve of ESCR, but the deafening silence on the opposition's part (excepting Dr. Meilaender's rather short piece) concerns me. Ironically, in the following section, sociologists Paul Root Wolpe and Glenn McGee note that the majority of the ESCR dialogue has been within a scientific community with an active interest in promoting ESCR. This seems to be just the case in this book.
The fourth chapter is a public policy section, with the aforementioned good essay by Wolpe and McGee on the nature of the ESCR debate. The essays treat issues like whether pressure will be exerted on women in fertility clinics to donate unused embryos to labs, whether the poor will get stem cell therapy, government oversight, and several other practical concerns that must be addressed if one promotes ESCR and any future applications it may bring. A few essays bear particular note: throughout the debates on ESCR in past three years 1999, I didn't hear much of the minority or feminist viewpoint on ESCR, so the opinions of Suzanne Holland (who appears earlier in Section II), Margaret McLean, and Cynthia Cohen were particularly handy. Thomas Shannon had some good points about whether the ESCR funding would deprive people of more basi public health programs.
On the whole, this is a useful book, but I suggest that in addition to reading the thoughts in this volume, you should check out Richard Doerflinger, the research ethics group Do No Harm or some of the others who oppose embryonic research. If this book were to do justice to both sides, it would be a truly first-class resource.
It's a start, but where's the debate?.......2002-01-04
Holland et al. created a good introduction to the public policy and science behind the current embryonic stem cell research (ESCR) debate, but while this book has "debate" in its title, there was little material disagreement between most of the contributors. A more robust, representative exchange of ideas would have made this book 5-star material.
The book is divided into several themes.The first three chapters are on the basic science and history of stem cell research, and the editors' choice of contributors is impeccable: they include James Thomson, who first isolated human embryonic stem cells, and Thomas Okarma, president and CEO of Geron Corp., which is the private firm that has spearheaded the development of Thomson's discoveries.
The second section segues from history to public policy and ethics, including analyses of the National Bioethics Advisory Committee's report on stem cells in 1999. This by and large was a good introduction to how the government, and specifically the Clinton administration, began to respond to stem cells. Erik Parens has a good article on how people tried to differentiate between the morality of experimenting on embryos from IVF clinics and embryos made specifically for research, and a few other dilemmas stemming from current human embryonic stem cell (hES) sources and protocols.
We then go into the third section, which contains religious perspectives on ESCR. This is where I found the term "debate" a misnomer, as for the exception of Gilbert Meilaender, a Protestant thelogian, all the religious commentators tried to show how their traditions could tolerate, if not actively approve of, ESCR. Now I know that many religious people approve of ESCR, but the deafening silence on the opposition's part (excepting Dr. Meilaender's rather short piece) concerns me. Ironically, in the following section, sociologists Paul Root Wolpe and Glenn McGee note that the majority of the ESCR dialogue has been within a community with an active interest in promoting ESCR. This seems to be just the case in this book.
The fourth chapter is a public policy section, with the aforementioned good essay by Wolpe and McGee on the nature of the ESCR debate. The essays treat issues like whether pressure will be exerted on women in fertility clinics to donate unused embryos to labs, whether the poor will get stem cell therapy, government oversight, and several other practical concerns that must be addressed if one promotes ESCR and any future applications it may bring. During the height of the ESCR debate, I didn't hear much of the minority or feminist viewpoint on ESCR, so the opinions of Suzanne Holland (who appears earlier in Section II), Margaret McLean, and Cynthia Cohen were particularly handy.
On the whole, this is a useful book, but I suggest that in addition to reading the thoughts in this volume, you should check out Richard Doerflinger, the research ethics group Do No Harm or some of the others who oppose embryonic research. If this book were to do justice to both sides, it would be a much better resource.
Must read on timely issue.......2001-11-03
Stem cells- the leading newspaper topic before the September 11 horrors and a topic to which we are of necessity returning. This book is an amazingly readable compilation of information on the science, the positions. the impact of the research (or failure to do the research),and the pros and cons of regulation. In a time when not only the government's but also the public's views on this issue are in a constant state of review, these editors have managed to pull together a collection that will not become a stale item, even though addressing a "hot" topic. The selections are ones that someone without medical or research scientist training can readily understand, yet not simplistic to the extent of ever bordering on boring. Truly a must read.
Book Description
This textbook for instruction in biomedical research ethics can also serve as a valuable reference for medical professionals and bioethicists. The 149 cases included in the book are grouped in nine chapters, each of which covers a key area of debate in the field. Some of the case studies are classics, including the famous cases of the Tuskegee Syphilis Study (in which subjects with syphilis were not given treatment) and the Willowbrook hepatitis studies (in which institutionalized subjects were intentionally exposed to hepatitis). Others focus on such current issues as human embryonic stem cell research, cloning by somatic nuclear transfer, and the design and function of institutional review boards. Each chapter begins with a brief introduction that places the issues raised in context; this is followed by a number of cases (each of which is no more than a few pages). Study questions meant to encourage further discussion follow each case.
After an introductory discussion of the history and tenets of ethics in medical research, the book's chapters cover oversight and study design; informed consent; the selection of subjects; conflicts of interest; the social effects of research; embryos, fetuses, and children; genetic research; the use of animals; and authorship and publication. Following these chapters are appendixes with the texts of the Nuremburg Code and the Declaration of Helsinki, two key documents in the establishment of bioethical standards for research. Also included are a glossary, a table of cases by general category, and an alphabetical listing of cases.
Book Description
Engendering International Health presents the work of leading researchers on gender equity in international health. Growing economic inequalities reinforce social injustices, stall health gains, and deny good health to many. In particular, deep-seated gender biases in health research and policy institutions combine with a lack of well-articulated and accessible evidence to downgrade the importance of gender perspectives in health. The book?s central premise is that unless public health changes direction, it cannot effectively address the needs of those who are most marginalized, many of whom are women.
The book offers evidence and analysis for both low- and high-income countries, providing a gender and health analysis cross-cut by a concern for other markers of social inequity, such as class and race. It details approaches and agendas that incorporate, but go beyond, commonly acknowledged issues relating to women's health; and it brings gender and equity analysis into the heart of the debates that dominate international health policy.
Customer Reviews:
Ironic.......2004-06-27
Only relatively recently has gender emerged as a cause of health inequity. By contrast, for over a century, it has been recognised that the wealthy have access to better health care than the poor. In developed countries, universal health care lessens this inequity. But developing countries still have this burden, plus a newly recognised inequity due to gender.
This book explains the latter. Both in developed and developing countries. The authors found that there are measurable differences in healthcare. The starkest differences are in poor countries, or the poor sections of developed countries. They also raise concern that structural macroeconomic reforms in a poor country, perhaps (often?) to better service its foreign debt, might have the unforeseen impact of worsening healthcare amongst its women. If so, it would be grimly ironic, because these reforms are often aimed at ultimately helping that nation.
Book Description
This examination of end-of-life decision making offers a broader perspective than that found in the extensive existing literature on this topic by offering a cross-national comparison. Experts from twelve countries analyze death-related issues and policies in their respective nations, discussing such topics as health care costs, advance directives or wills, pain management, and cultural, social, and religious factors. The countries selected for study -- Brazil, China, Germany, India, Israel, Japan, Kenya, the Netherlands, Taiwan, Turkey, the United Kingdom, and the United States -- represent a mix of East and West, developed and developing nations seldom considered together in analyses of these issues. This is the first systematic attempt to analyze end-of-life issues in many of these countries; the chapters on China, Kenya (of special significance because of the HIV/AIDS epidemic in sub-Saharan Africa) and Turkey break new ground.
Each author reports on various factors in end-of-life decisions: estimated costs of dying, including health care costs; the proportion of deaths occurring in hospitals, in hospices, and at home; the prevalence and variety of advance directives; the mix of high technology and palliative care; the cut-off point for aggressive care and the legal definition of death; government policies on end-of-life decisions, assisted suicide, and euthanasia; and cultural, social, and religious influences. The findings show that there are great differences among countries even in the way these issues are framed. Scholars, policymakers, and medical practitioners can all benefit from the extensive information in these essays on how different nations are dealing with death-related issues.
Book Description
In this book, Norman Cantor analyzes the legal and moral status of people with profound mental disabilities -- those with extreme cognitive impairments that prevent their exercise of medical self-determination. He proposes a legal and moral framework for surrogate medical decision making on their behalf. The issues Cantor explores will be of interest to professionals in law, medicine, psychology, philosophy, and ethics, as well as to parents, guardians, and health care providers who face perplexing issues in the context of surrogate medical decision making.
The profoundly mentally disabled are thought by some moral philosophers to lack the minimum cognitive ability for personhood. Countering this position, Cantor advances both theoretical and practical arguments for according them full legal and moral status . He also argues that the concept of intrinsic human dignity should have an integral role in shaping the bounds of surrogate decision making. Thus, he claims, while profoundly mentally disabled persons are not entitled to make their own medical decisions, respect for intrinsic human dignity dictates their right to have a conscientious surrogate make medical decisions on their behalf. Cantor discusses the criteria that bind such surrogates. He asserts, contrary to popular wisdom, that the best interests of the disabled person are not always the determinative standard: the interests of family or others can sometimes be considered. Surrogates may even, consistent with the intrinsic human dignity standard, sometimes authorize tissue donation or participation in nontherapeutic medical research by profoundly disabled persons. Intrinsic human dignity limits the occasions for such decisions and dictates close attention to the preferences and feelings of the profoundly disabled persons themselves. Cantor also analyzes the underlying philosophical rationale that makes these decision-making criteria consistent with law and morals.
Book Description
As our scientific and technical abilities expand at breathtaking speeds, concern that modern genetics and bioengineering are leading us to a posthuman future is growing. Is Human Nature Obsolete? poses the overarching question of what it is to be human against the background of these current advances in biotechnology. Its perspective is philosophical and interdisciplinary rather than technical; the focus is on questions of fundamental ontological importance rather than the specifics of medical or scientific practice.
The authors -- all distinguished scholars in their fields -- take on questions about technology's goals and values that are often ignored or sidelined in the face of rapid scientific advances and the highly specialized nature of technical knowledge. The essays included represent a rich variety of thought, ranging from finely nuanced philosophical and theological arguments to historical studies and cultural commentaries. Several explore the historical background of today's biotechnology: Timothy Casey traces such developments as the emergence of cybernetic humanity from Cartesian dualism, and Diane Paul presents the history of "positive" versus coerced eugenics. Jean Bethke Elshtain discusses cloning as a "messianic project" to perfect the body and exclude natural diversity -- giving as an example the elimination of Down Syndrome as an acceptable human type -- while Harold Baillie calls for an examination of the metaphysical roots of personhood. Robert Proctor finds no evidence in paleontology for any "essence of humanity," and Tom Shannon argues against materialist reductionism. Addressing social concerns, Lisa Sowle Cahill finds the possibility of a political solution to the problems raised by genetic engineering in Catholic teachings on social justice, and Langdon Winner looks critically at the "scientific enthusiasts of a posthuman future." Taken as a whole, the book provides a humanistic overview of a subject too often considered only in its technological aspect.
Book Description
The war on terrorism and the threat of chemical and biological weapons have brought a new urgency to already complex moral and bioethical questions. In the Wake of Terror presents thought-provoking essays on many of the troubling issues facing American society, written by experts from the fields of medicine, health care policy, law, political science, history, philosophy, and theology.
One of the first potential casualties of catastrophic circumstances is civil liberties. In the past, medical experiments conducted for national security purposes have violated ethical standards, and this book questions whether current policy provides sufficient safeguards against further abuses. It also focuses on public health issues, offering contrasting views on the extent to which civil authorities should be allowed to restrict freedom of movement in the name of national security and debating whether aggressive public health interventions improve public confidence and cooperation or detract from them.
A major area of concern is preparedness for future terrorist attacks. Chapters are devoted to ethical issues involved in the development, distribution, and rationing of vaccines and antidotes; resource allocation and medical triage; the moral duties of emergency health workers and other first responders; and the obligations of private entities such as managed care organizations and pharmaceutical companies. Contributors also address the implications of terrorism for our health insurance system and the role of genetic advances in bioterrorism. Underlying all of these issues, the authors argue, is the need to maintain a spirit of social solidarity, which can in turn only be achieved if preparations are publicly acknowledged and generally regarded as both prudent and fair.
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- The Fiber35 Diet: Nature's Weight Loss Secret
- The Human Body (An Illustrated Guide to Its Structure, Function, and Disorders)
- The Last Town on Earth: A Novel
- The Man Who Fell to Earth (Del Rey Impact)
- The Mature Mind: The Positive Power of the Aging Brain
- The Rise of the Creative Class: And How It's Transforming Work, Leisure, Community and Everyday Life
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Ethics & Morality
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| Books
Classic Cases in Medical Ethics: Accounts of Cases That Have Shaped Medical Ethics, with Philosophical, Legal, and Historical Backgrounds
Principles of Biomedical Ethics
Intervention and Reflection: Basic Issues in Medical Ethics
Taking Sides: Clashing Views on Controversial Bioethical Issues (Taking Sides: Clashing Views on Controversial Bio-Ethical Issues)
Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine
