The Cambridge Textbook of Bioethics

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 11
Acknowledgements......Page 18
Audience of the book......Page 19
Aims of the book......Page 20
Bioethical methodologies and our approach......Page 21
REFERENCES......Page 23
SECTION I Information problems......Page 25
Introduction......Page 27
What is consent?......Page 29
Law......Page 30
Empirical studies......Page 31
The cases......Page 32
REFERENCES......Page 33
Ethics......Page 35
Empirical studies......Page 36
How should I approach capacity in practice?......Page 37
Information......Page 38
Documentation......Page 39
REFERENCES......Page 40
Law......Page 42
Standards of disclosure......Page 43
Empirical studies......Page 44
How should I approach disclosure in practice?......Page 45
The cases......Page 46
REFERENCES......Page 47
Ethics......Page 49
Law......Page 50
Empirical studies......Page 51
The cases......Page 52
REFERENCES......Page 53
Ethics......Page 54
Law......Page 55
Patients......Page 56
How should I approach truth telling in practice?......Page 57
REFERENCES......Page 58
What is confidentiality?......Page 61
Law......Page 62
Policy......Page 63
How should I approach confidentiality in practice?......Page 64
The cases must decide if the potential harm is sufficiently......Page 65
REFERENCES......Page 66
SECTION II End of life care......Page 67
Introduction......Page 69
What is quality end of life care?......Page 71
Empirical studies......Page 72
Use of life-sustaining treatments......Page 73
REFERENCES......Page 74
What is substitute decision making?......Page 76
Law......Page 77
How should I approach substitute decision making in practice?......Page 78
How should decisions be made for persons who have lost decision-making capacity?......Page 79
How can substitute decision making be improved?......Page 80
The cases......Page 81
REFERENCES......Page 82
Ethics, law, and policy......Page 83
How should I approach advance care planning in practice?......Page 84
Respecting culture......Page 85
A practical approach......Page 86
The cases......Page 87
REFERENCES......Page 88
Ethics......Page 90
Law......Page 91
Empirical studies......Page 92
REFERENCES......Page 93
Why is conflict in the healthcare setting at the end of life important?......Page 96
How should I approach conflict in the healthcare setting at the end of life in practice?......Page 97
Family features that contribute to conflicts......Page 98
Healthcare provider features......Page 99
Social and organizational features......Page 100
REFERENCES......Page 101
What is brain death?......Page 103
Medical–biological formulation......Page 104
Trust......Page 105
How should I approach brain death in practice?......Page 106
REFERENCES......Page 108
SECTION III Pregnant women and children......Page 111
Introduction......Page 113
What are ethical dilemmas in the care of pregnant women?......Page 115
Ethics......Page 116
Law......Page 117
Empirical studies......Page 118
The cases......Page 119
REFERENCES......Page 120
What is prenatal testing and newborn screening?......Page 122
Ethics......Page 123
Empirical studies......Page 124
How should I approach prenatal testing and newborn screening in practice?......Page 125
The cases......Page 126
REFERENCES......Page 127
What is assisted reproduction?......Page 130
Why is assisted reproduction important?......Page 131
Informed choice......Page 132
Genetic determination......Page 133
How should I approach assisted reproduction in practice?......Page 134
REFERENCES......Page 135
Sweden......Page 138
Ethics......Page 139
Law......Page 141
How should healthcare professionals respectfully involve a child in medical decision making in practice?......Page 142
REFERENCES......Page 143
What are non-therapeutic pediatric interventions?......Page 145
Why are non-therapeutic pediatric interventions important?......Page 146
How should I approach non-therapeutic pediatric interventions in practice?......Page 147
The case......Page 148
RECOMMENDED READING......Page 149
Why are ethical issues regarding child abuse and neglected important?......Page 150
REFERENCES......Page 155
SECTION IV Genetics and biotechnology......Page 159
Introduction......Page 161
Ethics......Page 163
Policy......Page 165
Empirical studies......Page 166
The cases......Page 167
REFERENCES......Page 168
Transplantation organizations......Page 170
What is regenerative medicine?......Page 171
Ethics......Page 172
Law......Page 173
Empirical studies......Page 174
The cases......Page 175
REFERENCES......Page 176
What is genetic testing and screening?......Page 178
Ethics......Page 179
Law......Page 180
Empirical studies......Page 181
The cases......Page 182
REFERENCES......Page 183
What is bio-banking?......Page 184
General issues......Page 185
Bio-banking 169......Page 187
Postmortem issues......Page 188
The case......Page 189
REFERENCES......Page 190
What is behavioral genetics?......Page 192
Why is behavioral genetics important?......Page 194
Difference and discrimination......Page 195
Eugenics......Page 196
Empirical studies......Page 197
The cases......Page 198
REFERENCES......Page 199
SECTION V Research ethics......Page 201
Introduction......Page 203
Why is research ethics important?......Page 205
Law......Page 206
Policy......Page 207
How should I approach research ethics in practice?......Page 208
The cases......Page 209
REFERENCES......Page 210
What is innovation?......Page 212
Ethics......Page 213
Law......Page 214
Empirical studies......Page 215
The cases......Page 216
REFERENCES......Page 217
What are clinical trials?......Page 219
Ethics......Page 221
Empirical studies......Page 222
REFERENCES......Page 223
Ethics......Page 225
Law......Page 226
Empirical studies......Page 227
How should I approach epidemiological research in practice?......Page 228
The case......Page 229
REFERENCES......Page 230
What is the dual role of clinician and researcher?......Page 232
Ethics......Page 233
Empirical data......Page 235
How should I approach the dual roles of physician and researcher in practice?......Page 236
REFERENCES......Page 237
What is financial conflict of interest in research?......Page 240
Safety and well-being of research subjects......Page 241
Distortion of the research agenda......Page 242
Regulatory remedies......Page 243
Novel approaches......Page 244
The case......Page 245
REFERENCES......Page 246
What is fetal and embryo research?......Page 249
Why is embryo and fetal research important and how should I approach it in practice?......Page 250
Fetal research......Page 251
Embryo research......Page 252
Policy......Page 253
REFERENCES......Page 254
SECTION VI Health systems and institutions......Page 257
Introduction......Page 259
REFERENCES......Page 260
What is organizational ethics?......Page 261
Law......Page 262
Policy......Page 263
Empirical studies......Page 264
The cases......Page 265
REFERENCES......Page 266
Why is priority setting important?......Page 269
Law......Page 270
Empirical studies......Page 271
How should I approach priority setting in practice?......Page 272
REFERENCES......Page 273
What is medical error?......Page 275
Ethics......Page 276
Policy......Page 277
Empirical studies......Page 278
How should I approach the disclosure of medical error in practice?......Page 279
REFERENCES......Page 280
What are conflicts of interest in education and patient care?......Page 284
Ethics......Page 285
Empirical studies......Page 286
Conflicts of interest in education......Page 287
Training and awareness raising......Page 288
The cases......Page 289
REFERENCES......Page 290
What is public health ethics?......Page 292
What is public health reporting and surveillance?......Page 293
What criteria are used to determine which diseases/conditions need reporting?......Page 294
Why is public health ethics important?......Page 295
The case......Page 296
REFERENCES......Page 297
What are emergency and disaster scenarios?......Page 299
Why is preparation for emergency and disaster scenarios important?......Page 300
Triage......Page 301
Quarantine......Page 302
How should I approach emergency and disaster scenarios in practice?......Page 303
REFERENCES......Page 304
What is rural healthcare ethics?......Page 307
Why is rural healthcare ethics important?......Page 308
Ethics......Page 309
Policy......Page 310
How should I approach rural healthcare ethics in practice?......Page 311
The cases......Page 312
REFERENCES......Page 313
What is community healthcare ethics?......Page 317
Why is community healthcare ethics important?......Page 318
A code of ethics for community health......Page 319
Ethics case documentation, review, and evaluation tools......Page 321
The case......Page 322
REFERENCES......Page 323
SECTION VII Using clinical ethics to make an impact in healthcare......Page 325
Introduction......Page 327
REFERENCES......Page 329
What is systems thinking in clinical ethics?......Page 331
Why is it important to apply systems thinking to clinical ethics?......Page 332
How should I apply systems thinking to clinical ethics in practice?......Page 333
Take advantage of economies of scale......Page 334
Be proactive, not reactive......Page 335
Maintain a constant improvement orientation......Page 336
Target root cause organizational factors that influence behavior......Page 337
References......Page 338
What is clinical ethics effectiveness?......Page 340
Strategy 1: the ‘‘hub and spokes’’ model for clinical ethics service delivery......Page 341
Strategy 3: ethics strategic planning......Page 343
Strategy 4: evaluation of clinical ethics services......Page 344
The case......Page 345
REFERENCES......Page 346
Why should I teach?......Page 347
How should I teach?......Page 348
How should I evaluate?......Page 350
REFERENCES......Page 351
Appendix: bioethics teaching resources......Page 352
SECTION VIII Global health ethics......Page 355
Introduction......Page 357
What is global health ethics?......Page 359
Global health: disparities and implications......Page 360
Understanding others......Page 361
Bioethics in the context of a more nuanced understanding of social relations......Page 362
How should I approach global health ethics in practice?......Page 363
The case......Page 364
REFERENCES......Page 365
What is torture?......Page 368
International human rights law......Page 369
Non-binding United Nations resolutions......Page 370
International medical ethics guidelines......Page 371
Extrajudicial renditions......Page 373
How should I act when encountering torture in practice?......Page 374
REFERENCES......Page 375
Why is access to medicines and corporate social responsibility important?......Page 377
Explaining the global drug imbalance......Page 378
Market failures......Page 379
Access to medicines and corporate social responsibility......Page 381
Corporate social responsibility and the right to essential medicines......Page 382
REFERENCES......Page 384
What are the obligations of international distributive justice?......Page 387
Global health......Page 388
Non-ideal theory......Page 389
How might the 1% obligation work in practice?......Page 390
REFERENCES......Page 392
SECTION IX Religious and cultural perspectives in bioethics......Page 395
Introduction......Page 397
What is Aboriginal bioethics?......Page 401
Themes in approaches to communication and caregiving......Page 402
Barriers......Page 404
Access to care......Page 405
The future of ethics and Aboriginal people......Page 406
The case......Page 407
Related websites......Page 408
What is Buddhist bioethics?......Page 409
How should I approach Buddhist ethics in practice?......Page 410
Abortion......Page 411
Euthanasia......Page 412
REFERENCES......Page 413
What is Chinese bioethics?......Page 415
Conceptions of illness......Page 416
Death and dying......Page 417
The case......Page 418
REFERENCES......Page 420
What are Hindu and Sikh bioethics?......Page 421
How should I approach Hindu and Sikh bioethics in practice?......Page 423
REFERENCES......Page 425
What is Islamic bioethics?......Page 426
The cases......Page 428
REFERENCES......Page 431
Related websites......Page 433
What is Jehovah’s Witnesses?......Page 434
Views on blood and blood transfusion......Page 435
Views on mental health......Page 436
Why is Jehovah’s Witness bioethics important?......Page 437
How should I approach Jehovah’s Witness bioethics in practice?......Page 438
The cases......Page 439
REFERENCES......Page 440
Jewish bioethics......Page 442
A variety of approaches......Page 443
Why is Jewish bioethics important?......Page 444
The case......Page 445
Related websites......Page 447
Origins of Protestantism......Page 448
Concepts relevant to bioethics......Page 449
Why is Protestant bioethics important?......Page 450
End of life care......Page 451
REFERENCES......Page 452
Related websites......Page 453
What is Catholic bioethics?......Page 454
How should I approach Catholic bioethics in practice?......Page 455
Research involving human subjects......Page 456
The case......Page 457
REFERENCES......Page 458
Related websites......Page 459
SECTION X Speciality bioethics......Page 461
Introduction......Page 463
Patient–surgeon relationship......Page 465
Informed consent......Page 466
Emergency patients......Page 467
The preoperative conference......Page 468
The case......Page 469
REFERENCES......Page 470
The competent patient with intact autonomy......Page 472
The competent ‘‘patient’’ with compromised autonomy......Page 473
Do-not-resuscitate in the operating room......Page 475
Physician participation in executions......Page 476
REFERENCES......Page 477
What is critical and intensive care ethics?......Page 480
Triage......Page 481
End of life care......Page 482
The cases......Page 484
REFERENCES......Page 485
What is emergency and trauma ethics?......Page 487
Law......Page 488
How should I approach emergency and trauma ethics in practice?......Page 489
The cases......Page 490
REFERENCES......Page 491
What is primary care ethics?......Page 493
Towards preventive ethics in primary care......Page 494
The cases......Page 496
REFERENCES......Page 497
Ethics......Page 499
Policy......Page 501
How should doctors approach ethical problems of infectious disease in practice?......Page 502
The case......Page 503
REFERENCES......Page 504
Why is psychiatric ethics important?......Page 505
Ethical aspects of psychiatric treatment......Page 506
Values and psychotherapy......Page 507
The right to effective treatment......Page 508
Involuntary treatment......Page 509
The case......Page 510
REFERENCES......Page 511
What is neuroethics?......Page 513
Ethics......Page 514
Policy......Page 516
Direct-to-consumer advertising and public understanding of neuroscience......Page 517
Risks of neuroimaging research and incidental findings......Page 518
Self-referred imaging and direct-to-consumer advertising......Page 519
REFERENCES......Page 520
Why is pharmacy ethics important?......Page 523
Conflicts between dispensing and clinical services......Page 524
Patient advocacy......Page 525
Using prescription records to assist the marketing activity of pharmaceutical companies......Page 526
Medical resource stewardship......Page 527
The case......Page 528
REFERENCES......Page 529
Codes of ethics......Page 530
Ethics......Page 531
Law......Page 532
Empirical studies......Page 535
How should I approach complementary and alternative medical therapies in practice?......Page 536
REFERENCES......Page 537
Index......Page 539