The rapidly changing face of modern medicine and the increasing involvement of public debate in its practice, are reflected in the wide range of contributions to this book, which takes a searching look at the issues which are currently at the forefront of modern debate in medical ethics and the law.

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

From Hippocrates to paternalism to autonomy : the new hegemony -- From autonomy to consent -- Consent, autonomy, and the law -- Autonomy at the end of life -- Autonomy and pregnancy -- Autonomy and genetic information -- Autonomy and organ transplantation -- Autonomy, consent, and the law.

The system of clinical ethics committees (CECs) in the United Kingdom is based on goodwill. No formal requirements exist as to constitution, membership, range of expertise or the status of their recommendations. Healthcare professionals are not obliged to use CECs where they exist, nor to follow any advice received. In addition, the make-up of CECs suggests that ethics itself may be under-represented. In most cases, there is one member with a training in ethics – the rest are healthcare professionals or (...) administrators, although a lawyer is generally also included in the membership. This begs the question as whether CECs can ‘do ethics’, as well whether or not they can take seriously the requirements of due process, formal justice and human rights. Moreover, the role of the patient in this system is opaque. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o improve (...) medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients. Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients . Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

Xenotransplantation - the transfer of living tissue between species - has long been heralded as a potential solution to the severe organ shortage crisis experienced by the United Kingdom and other 'developed' nations. However, the significant risks which accompany this biotechnology led the United Kingdom to adopt a cautious approach to its regulation, with the establishment of a non-departmental public body - UKXIRA - to oversee the development of this technology on a national basis. In December 2006 UKXIRA was quietly (...) disbanded and replaced with revised guidance, which entrusts the regulation of xenotransplantation largely to research ethics committees. In this article we seek to problematize this new regulatory framework, arguing that specialist expertise and national oversight are necessary components of an adequate regulatory framework for a biotechnology which poses new orders of risk, challenges the adequacy of traditional understandings of autonomy and consent, and raises significant animal welfare concerns. We argue for a more considered and holistic approach, based on adequate consultation, to regulating biotechnological developments in the United Kingdom. (shrink)

Topics discussed in this work are abortion, euthanasia, medical negligence and human experimentation.

Issues surrounding the end of life, and in particular questions of patient choice, have seldom been so high on the legal, ethical and political agenda. This book examines these issues from a comparative perspective, drawing conclusions about the role of the doctor, the individual and the law-makers in this moral minefield.

pt. 1. Background you need. -- What is brain-compatible teaching -- The old and new of it -- When brain research is applied to the classroom everything will change -- Change can be easy -- We're not in Kansas anymore -- Where's the proof -- Tools for exploring the brain -- Ten reasons to care about brain research -- The evolution of brain models -- Be a brain-smart consumer: recognizing good research -- Action or theory: who wants to read all (...) that research -- Excellent sources of research -- Fun factoids on the brain -- What's in the human brain -- Brain teaser -- The brain divided -- The brain connected -- Brain geography -- Brain "cell" ebration: far-out facts about brain cells -- Learning happens but how -- Are today's kids different -- Boy's and girl's brain differences -- Learning disabilities; different brains -- The cranial soup bowl: understanding the chemicals in our brains -- pt. 2. The foundation for teaching is principles, not strategies. What are the principles -- Principle 1: the principle of change: brain is dynamic, not fixed -- Principle 2: the principle of variety: all brains are unique -- Principle 3: the principle of developmental sensitivity -- Principle 4: the principle of interaction: we have a social brain -- Principle 5: the principle of connectivity: the brain is an integrated system of systems -- Principle 6: the principle of memory malleability -- Principle 7: the principle of resource consumption -- necessity for processing -- pt. 3. So what; now what. Asking big questions: what's in a brain-compatible curriculum -- Brain-compatible test-taking success strategies -- Systemic change: the next level -- Big picture analysis: transformation happens -- Action research makes a difference -- The learning community -- What's next. (shrink)

A medical profession which did not seek improved means to conquer disease would be condemned for dereliction of its duty, Members of the public will not accept the current state of the medical arts as finite but feel justified in expecting the development of more effective therapies for illness, and the promotion of improved means of preventive care.With this assertion, the distinguished academic, Bernard Dickens, places research firmly in the domain of the public interest. Foster agrees, saying that, “[t]o improve (...) medical care as much as we can, if not to perfect it, means that we have to accept the need for research.” Giesen adds a further emphasis to the search for medical advancements, saying that “freedom of research and scientific inquiry is, in itself, an important aspect of open societies.“. (shrink)

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

Title: Medicine, Morals, and the LawPublisher: Gower Pub CoISBN: 0566005336Author: Sheila McLean and Gerry MaherTitle: Reproductive EthicsPublisher: Prentice HallISBN: 0137739044Author: Michael BaylesTitle: Ethics of Withdrawal of Life-Support SystemsPublisher: Praeger PaperbackISBN: 0275927105Author: Douglas N. Walton.

La relacion entre la etica y la medicina tiene una larga historia y tradicion que se puede remontar hasta la Grecia, China e India clasicas. La relacion entre ambas disciplinas es muy intensa porque la pregunta etica sobre el que debo hacer se aplica sobre la pregunta medica sobre que es mejor para la salud y el bienestar de una persona. Los textos que componen este libro tienen como hilo conductor el principio de autonomia. Este principio implica que las elecciones (...) individuales de planes de vida son valiosas y, por lo tanto, el Estado no debe interferir en ellas (dimension negativa) y debe disenar instituciones que faciliten la persecucion individual de estos planes de vida (dimension positiva). En los textos se observa que este enfoque eminentemente subjetivo se enfrenta a un enfoque colectivo (dimension relacional) que recuerda que las decisiones individuales se adoptan y repercuten positiva y negativamente en un entorno social. Este enfrentamiento permitiria observar que las elecciones individuales solo tienen un valor prima facie, pudiendose en algunos justificar limites mas amplios. (shrink)

The power of technology? -- Risk and responsibility? -- The ethical anatomy of disasters? -- Remaking nature? -- Tinkering with humans? -- Information's wild frontiers? -- Whose knowledge, whose property? -- Reclaiming the future? -- The ethics of invention?

STS research has devoted relatively little attention to the promotion and reception of science and technology by non-scientific actors and institutions. One consequence is that the relationship of science and technology to political power has tended to remain undertheorized. This article aims to fill that gap by introducing the concept of sociotechnical imaginaries. Through a comparative examination of the development and regulation of nuclear power in the US and South Korea, the article demonstrates the analytic potential of the imaginaries concept. (...) Although nuclear power and nationhood have long been imagined together in both countries, the nature of those imaginations has remained strikingly different. In the US, the state’s central move was to present itself as a responsible regulator of a potentially runaway technology that demands effective containment. In South Korea, the dominant imaginary was of atoms for development which the state not only imported but incorporated into its scientific, technological and political practices. In turn, these disparate imaginaries have underwritten very different responses to a variety of nuclear shocks and challenges, such as Three Mile Island (TMI), Chernobyl, and the spread of the anti-nuclear movement. (shrink)

This collection of essays by Sheila Jasanoff explores how democratic governments construct public reason, that is, the forms of evidence and argument used in making state decisions accountable to citizens.

Economics has developed into one of the most specialised social sciences. Yet at the same time, it shares its subject matter with other social sciences and humanities and its method of analysis has developed in close correspondence with the natural and life sciences. This book offers an up to date assessment of economics in relation to other disciplines. -/- This edited collection explores fields as diverse as mathematics, physics, biology, medicine, sociology, architecture, and literature, drawing from selected contributions to the (...) 2005 Annual Conference of the European Society for the History of Economic Thought (ESHET). There is currently much discussion at the leading edges of modern economics about openness to other disciplines, such as psychology and sociology. But what we see here is that economics has drawn on (as well as contributed to) other disciplines throughout its history. In this sense, in spite of the increasing specialisation within all disciplines, economics has always been an open discipline and the chapters in this volume provide a vivid illustration for this. -/- Open Economics is a testament to the intellectual vibrancy of historical research in economics. It presents the reader with a historical introduction to the disciplinary context of economics that is the first of its kind, and will appeal to practising economists and students of the discipline alike, as well as to anybody interested in economics and its position in the scientific and social scientific landscape. -/- Table of Contents -/- Introduction: Economics in relation to other disciplines Richard Arena, Sheila Dow and Matthias Klaes Part I. Economics in relation to the humanities and social sciences 1. The social science of economics Brian J. Loasby 2. Economics and literature Bruna Ingrao 3. Happiness: what Kahneman could have learnt from Pietro Verri Pier Luigi Porta Part II. Economics in relation to the life and natural sciences 4. Newtonian physics, experimental moral philosophy and the shaping of political economy Sergio Cremaschi 5. Evolutionary biology and economic behaviour: re-visiting Veblen's instinct of workmanship Mark Harrison 6. Medicine and economics in pre-classical economics Alain Clément and Ludovic Desmedt Part III. Economics and mathematics 7. Mathematics as the role model for neoclassical economics Nicola Giocoli 8. The role of econometric method in economic analysis: A reassessment of the Keynes-Tinbergen debate, 1938-43 Giovanna Garrone and Roberto Marchionatti IV. Economics and architecture 9. Economics and architecture Maurice Lagueux 10. Economic policies and urban development in Latin America Michele Alacevich and Andrea Costa V. Economics and geography 11. ‘Space’ in economic thought Giovanna Vertova 12. Economics, geography and colonialism in the writings of William Petty Hugh Goodacre Part VI. Economics and sociology 13. Economics and sociology: Gustav Schmoller and Werner Sombart on social differentiation Joachim Zweynert 14. Is Homo Oeconomicus a 'bad guy'? Isabelle This Saint-Jean -/- . (shrink)

In the past twenty years, the field of science and technology studies (S&TS) has made considerable progress toward illuminating the relationship between scientific knowledge and political power. These insights have not yet been synthesized or presented in a form that systematically highlights the connections between S&TS and other social sciences. This timely collection of essays by some of the leading scholars in the field attempts to fill that gap. The book develops the theme of "co-production", showing how scientific knowledge both (...) embeds and is embedded in social identities, institutions, representations and discourses. Accordingly, the authors argue, ways of knowing the world are inseparably linked to the ways in which people seek to organize and control it. Through studies of emerging knowledges, research practices and political institutions, the authors demonstrate that the idiom of co-production importantly extends the vocabulary of the traditional social sciences, offering fresh analytic perspectiveson the nexus of science, power and culture. (shrink)

What might become of anthropology if it were to suspend its sometime claims to be a social science? What if it were to turn instead to exploring its affinities with art and literature as a mode of engaged creative practice carried forward in a world heterogeneously composed of humans and other than humans? Stuart McLean claims that anthropology stands to learn most from art and literature not as "evidence" to support explanations based on an appeal to social context or (...) history but as modes of engagement with the materiality of expressive media--including language--that always retain the capacity to disrupt or exceed the human projects enacted through them. At once comparative in scope and ethnographically informed, Fictionalizing Anthropology draws on an eclectic range of sources, including ancient Mesopotamian myth, Norse saga literature, Hesiod, Lucretius, Joyce, Artaud, and Lispector, as well as film, multimedia, and performance art, along with the concept of "fabulation" (the making of fictions capable of intervening in and transforming reality) developed in the writings of Bergson and Deleuze. Sharing with proponents of anthropology's recent "ontological turn," McLean insists that experiments with language and form are a performative means of exploring alternative possibilities of collective existence, new ways of being human and other than human, and that such experiments must therefore be indispensable to anthropology's engagement with the contemporary world. (shrink)

'An extremely readable book that should provoke both economists and students of economic methodology to think more deeply about what they are doing.' Roger E. Backhouse, Professor of the History and Philosophy of Economics, University of BirminghamEconomic Methodology provides an accessible introduction to the subject-matter of and literature on the methodology of economics. It presents issues in economics in order to demonstrate the need for methodological awareness and debate. The core of the book then explains the content and development of (...) thought in methodology in relation to issues in economics, with an especial emphasis on the most recent thinking in the area. (shrink)

In 2005, Ethiopia changed its abortion law to curb its high maternal mortality. This has led to a considerable reduction in deaths from unsafe abortions. Abortion is now legal if the woman’s pregnancy is a result of rape or incest, if her health is endangered, if the fetus has a serious deformity, if she suffers from a physical or mental deficiency, or if she is under 18 years of age. The word of the woman, if in compliance with the law, (...) is sufficient to qualify for an abortion. In this context, where the law makes the door slightly open, health workers become important in deciding who gets access to safe services and who doesn’t, thus creating considerable ethical dilemmas. The objective of this study was to explore abortion service providers’ personal experiences and reflections, perceptions of the abortion law, and ethical and dilemmas that arise. Data collection took place from March to May 2016 in Addis Ababa, at different health clinics providing abortion services. Thirty in-depth interviews and three focus group discussions were conducted with 41 abortion service providers at governmental and non-governmental clinics. Content analysis was drawn upon in the interpretation of the findings. When working in a context where the law has slightly opened the door for abortion seeking women, the health workers describe conflicting concerns, burdensome responsibilities, and ambiguity concerning how to interpret and implement the law. They describe efforts to balance their religious faith and values against their professional obligations and concern for women’s health and well-being. This negotiation is particularly evident in the care of women who fall outside the law’s indications. They usually handle ethical dilemmas and decision-making alone without guidance. Moreover, many health workers face a stigma from fellow colleagues not performing abortions and therefore keep their job a secret from family and friends. Health workers in Ethiopia experience ethical dilemmas trying to maneuver between the abortion law, their personal values, and their genuine concern for the health of women. More research is needed to further explore this. (shrink)

As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

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This book is a comprehensive study of the Odyssey's plot, which shows how the motifs of disguise and recognition are used to articulate the central values of Homeric society. The story of Odysseus' homecoming is discussed in relation to family dynamics, heroic competition, the social institutions of marriage and hospitality, gender relations, and the enduring power of song.

Dreamscapes of Modernity offers the first book-length treatment of sociotechnical imaginaries, a concept originated by Sheila Jasanoff and developed in close collaboration with Sang-Hyun Kim to describe how visions of scientific and technological progress carry with them implicit ideas about public purposes, collective futures, and the common good. The book presents a mix of case studies—including nuclear power in Austria, Chinese rice biotechnology, Korean stem cell research, the Indonesian Internet, US bioethics, global health, and more—to illustrate how the concept (...) of sociotechnical imaginaries can lead to more sophisticated understandings of the national and transnational politics of science and technology. A theoretical introduction sets the stage for the contributors’ wide-ranging analyses, and a conclusion gathers and synthesizes their collective findings. The book marks a major theoretical advance for a concept that has been rapidly taken up across the social sciences and promises to become central to scholarship in science and technology studies. (shrink)