Our understanding of gender carries significant bioethical implications. An errant account of gender-specific disease can lead to overgeneralizations, undergeneralizations, and misdiagnoses. It can also lead to problems in the structure of health-care delivery, the creation of policy, and the development of clinical curricula. In this volume, Cutter argues that gender-specific disease and related bioethical discourses are philosophically integrative. Gender-specific disease is integrative because the descriptive roles of gender, disease, and their relation are inextricably tied to their prescriptive roles within (...) frames of reference. An integrative account of gender-specific disease carries ethical implications because our understanding of gender-specific disease is evaluative, and our evaluations of gender-specific disease entail judgments concerning the praiseworthiness and blameworthiness of a clinical event. Cutter supports a "both/and" emphasis on context and integration in relation to gender-specific disease and bioethical analyses. While the text mainly focuses on gender-specific diseases that affect women, Cutter also includes examples involving men, children, and members of the LGBT community. (shrink)

This book explores the ethical implications of managing uncertainty in clinical decision-making during the COVID-19 pandemic. It develops an ethics of clinical uncertainty that brings together insights from the clinical and biomedical ethical literatures. The book sets out to recognize the central role uncertainty plays in clinical decision-making and to acknowledge the different levels, kinds, and dimensions of clinical uncertainty. It also aims to aid clinicians and patients in managing clinical uncertainty, and to recognize the ethical duty they have to (...) manage clinical uncertainty. The book addresses four ethical duties related to clinical uncertainty: (1) the duty to advance the welfare of those in clinical medicine, (2) to respect the rights of those in clinical medicine, (3) to promote just access to health care, and (4) to care for one another in clinical medicine. These duties took on select urgency during the COVID-19 pandemic because clinical risk assessments about COVID-19 were limited, we were asked to give informed consent in the context of limited and changing knowledge, the pandemic unearthed myriad problems about the distribution of health care, and the pandemic raised questions about how we care for each other in medicine. An Ethics of Clinical Uncertainty will appeal to scholars, advanced students, and medical professionals working in philosophy of medicine, biomedical ethics, clinical medicine, nursing, public health care, and gerontology. (shrink)

The classification of clinical problems, such as AIDS, requires choices. Choices are made on epistemic (i.e., knowledge-based) and non-epistemic (i.e., action-based) grounds. That is, the ways in which we classify clinical problems, such as AIDS, involve a balancing of different understandings of clinical reality and of clinical values among participants of the clinical community. On this view, the interplay between epistemic and non-epistemic interests occurs within the embrace of particular clinical contexts.The ways in which we classify AIDS is the topic (...) of this paper. We consider the extent to which we construct clinical reality; we examine a suggested classification of AIDS; and we conclude suggesting that the choice regarding how to classify AIDS is the result of negotiation among participants in the clinical community. (shrink)

This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.

Examines the predicaments of medicine within a cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. This work shows that, in the postmodern age, two interrelated issues surface when it comes to medicine.

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established , how medical protocols are administered , how medical certainty is evaluated and medical responsibility is framed , and how medical knowledge is transmitted and how medical (...) care is allocated . The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical care is allocated. (...) The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

Thinking Through Breast Cancer is a philosophical analysis of breast cancer inspired by the author's journey as a breast cancer patient. It sets out to show the relevancy of philosophical thinking in medicine today and shares advice about how to navigate the uncertainty of breast cancer diagnosis, treatment, and survival.

In this essay, and in his honor, I focus on two of physician-philosopher H. Tristram Engelhardt, Jr.’s many contributions, namely, his view that biomedical ethics cannot offer a singular content-driven theoretical approach and requires an appreciation of epistemologies of knowing in medicine. While these two positions remain controversial, because we all want definitive answers to our questions concerning what we ought to do in medicine and elsewhere, Dr. Engelhardt’s view makes possible discussion and debate in medicine to include diverse, defensible (...) ways of knowing. In the end, Dr. Engelhardt’s approach in biomedical ethics is one of shared decision making and negotiation. This is an important model if we take respect for patients seriously in the clinical setting. (shrink)

Anthony Giddens’ theory of structuration is a theory of social action, which claims that society should be understood in terms of action and structure; a duality rather than two separate entities. This paper introduces some of the central characteristics of structuration theory, presenting a conceptual framework that helps to explore how people produce the systems and structures that shape their practice. By understanding how people produce and reproduce structures, then there is the potential for changing them. Criticisms that have been (...) raised about the theory are introduced, followed by examples of how the theory might be useful to nursing research. Structuration theory can be employed to explore how nurses produce, reproduce, and transform nursing practice through social interaction across time and space. (shrink)

Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the (...) potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing. (shrink)

This paper addresses the notorious logic and semantic difficulties encountered by Lévinas in articulating his ethics of alterity. Tracing the philosophical genesis of this question in Descartes and Heidegger, it recognises Lévinas's claim that there can be no ontological foundation for ethics because ontology would reduce ethics to a form of mathematical ratio. Lévinas is unwilling to deny his phenomenological experience of a desire for goodness and unable to deny his despair at his ontological alienation from the good and so (...) he is driven to seek an irrational link between the human being and a metaphysical ‘good beyond being’. Retrieving an ancient gnostic neo-Platonist working of the same problem from the work of Hans Jonas, the paper reconsiders Lévinas's reading of Plato, specifically his understanding of Socrates’ exposition of erosin the Phaedo, in order to illustrate how his ethics of alterity may allow the human being to refer irrationally to the good beyond being. (shrink)

In the study of organ and tissue transplantation, the focus tends to be on donation. But where there is “giving,” there is also “getting:” receiving help. Altruism, helping behavior, and the exchange of benefits have received extensive attention from social psychological researchers. The gift exchange described by anthropologist Marcel Mauss provides a framework for reviewing this social psychological research on altruism and exchange and applying it to transplantation. An overall conclusion is that altruistic donation is not so ethically or clinically (...) problematic, while receiving help has a complex psychosocial context that needs to be acknowledged and given more attention. (shrink)

This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status of (...) non-human animals. (shrink)

Does birth make a difference to the moral rights of the fetus/infant? Should it make a difference to its legal rights? Most contemporary philosophers believe that birth cannot make a difference to moral rights. If this is true, then it becomes difficult to justify either a moral or a legal distinction between late abortion and infanticide. I argue that the view that birth is irrelevant to moral rights rests upon two highly questionable assumptions about the theoretical foundations of moral rights. (...) If we reject these assumptions, then we are free to take account of the contrasting biological and social relationships that make even relatively late abortion morally different from infanticide. (shrink)

"Readers interested in feminist studies, applied ethics, or social and political philosophy should find Gendercide especially interesting and informative. Highly recommended."-CHOICE.

The Forum and the Tower tackles a fascinating and perennial topic: the relationship between the academy and the world of politics. The accomplished Harvard law professor Mary Ann Glendon traces this crucial relationship from Classical Greece taking readers through the Roman Empire, Renaissance Italy, the English revolution, the Federalist era in the US, the French Revolution, the Napoleonic wars, the Concert of Europe, the progressive era, and the New Deal/World War II era.

This chapter contains sections titled: What is Moral Status? The Moral Agency Theory The Genetic Humanity Theory The Sentience Theory The Organic Life Theory Two Relationship‐based Theories Combining these Criteria Principles of Moral Status Human Zygotes, Embryos, and Fetuses Are All Animals Equal? Machines and Artificial Life‐forms Conclusion.

In the Philippines, all transplant centers are mandated by the Department of Health (DOH) to have a Hospital Transplant Ethics Committee (HTEC) to ensure that donations are altruistic, voluntary and free of coercion/commercial transactions. This study was undertaken primarily to describe the organizational and functional profile of existing HTECs and identify areas for improvement. This is a descriptive cross‐sectional study. There was variation in their logistical arrangements (support from hospital, filing systems, office spaces), operations (length and frequency of meetings, number (...) of referrals) and membership (composition, qualifications, occupation, training). The approval rate for donor‐recipient pairs is high with the majority of cases made by living non‐related donors. Appropriate reasons were cited for rejection. The perception of HTECs is that they are competent and confident in their decision‐making. However, there is a need to standardize HTEC composition, provide operating procedures and additional training which can be done by the DOH. (shrink)