McLean, Sheila. A Patient’s Right to Know: Information Disclosure, the Doctor and the Law
1995, Aldershot: Dartmouth.
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Added by: Simon FoktPublisher’s Note:
Comment : This volume addresses issues concerning the rights of patients. Particular issues examined include the patient's right to consent to or refuse treatment, and issues related to valid consent and its dependence on information, including full details regarding the risks associated with a particular course of treatment. Useful as further reading in applied ethics classes, or in any moral or political philosophy teaching related to consent. Additionally, can be useful in discussions on the differences and similarities between the moral and legal approaches to the issue of consent.O'Neill, Onora. Some limits of informed consent2003, Journal of Medical Ethics 29 (1):4-7-
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Added by: Simon Fokt
Abstract: Many accounts of informed consent in medical ethics claim that it is valuable because it supports individual autonomy. Unfortunately there are many distinct conceptions of individual autonomy, and their ethical importance varies. A better reason for taking informed consent seriously is that it provides assurance that patients and others are neither deceived nor coerced. Present debates about the relative importance of generic and specific consent (particularly in the use of human tissues for research and in secondary studies) do not address this issue squarely. Consent is a propositional attitude, so intransitive: complete, wholly specific consent is an illusion. Since the point of consent procedures is to limit deception and coercion, they should be designed to give patients and others control over the amount of information they receive and opportunity to rescind consent already given.Comment : A great introductory text offering a short overview of the problems related to consent. The point regarding the intransitivity of consent is likely to inspire interesting discussions. As the paper is quite short, it can easily be used in conjunction with other texts.O'Neill, Onora. Medical and Scientific Uses of Human Tissue1996, Journal of Medical Ethics 22: 5-7.-
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Added by: Rochelle DuFord
Abstract: Inevitably a policy-oriented report on issues as complex and as rapidly changing as the medical and scientific uses of human tissue can achieve neither philosophical purity nor regulatory completeness. The council's strategy has been to begin with robust ethical principles, for which sound philosophical arguments can be given, which will (it is hoped) command widespread support. The council went on to argue for guidelines of sufficient, but not vapid, generality which could be of practical use to the various medical intermediaries, professional and regulatory bodies and research ethics committees which will carry out the tasks of detailed regulation and of making decisions that affect uses of human tissue. The council's hope is that the recommendations of the report can be absorbed into regulatory and professional practice, and where needed into government policy. If they can, the increasing diversity of uses of human tissues need lead neither to overt nor to covert 'commercialisation of the human body', but will also not put unnecessary restrictions on advances in research and medical practice.Comment : This text provides a quick introduction to, and overview of, ethical positions concerning the use of human tissue in scientific and medical research (including utilitarianism, rights, property rights, and dignity). It would be an excellent reading for introducing a unit on research concerning human tissue in a bioethics or medical ethics course. It would make sense to teach it as a framework for understanding moral and policy issues involved in the case of Henrietta Lacks or HeLa cells.O'Neill, Onora. Autonomy and Trust in Bioethics2002, Cambridge University Press.-
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Added by: Chris Howard, Contributed by: Simon Fokt
Publisher's Note: Onora O'Neill suggests that the conceptions of individual autonomy (so widely relied on in bioethics) are philosophically and ethically inadequate; they undermine rather than support relationships based on trust. Her arguments are illustrated by issues raised by such practices as the use of genetic information by the police, research using human tissues, new reproductive technologies, and media practices for reporting on science, medicine, and technology. The study appeals to a wide range of readers in ethics, bioethics, and related disciplines.Comment : Parts of this book are an excellent supplement to units on autonomy and informed consent in an intermediate-advanced level medical ethics course. In particular, chapters 1, 2, and 4 would be excellent additions to a unit on autonomy, and chapter 7 would be a similarly excellent addition to a unit on informed consent.Peter, Elizabeth, Liaschenko, Joan. Moral Distress Reexamined: A Feminist Interpretation of Nurses’ Identities, Relationships, and Responsibilites2013, The Journal of Bioethical Inquiry. 10: 337–345.-
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Added by: Chris Blake-TurnerAbstract:
Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.Comment (from this Blueprint): Moral distress is, roughly, when a healthcare worker is institutionally constrained to act against their best moral judgement. A typical example is a nurse being prevented from giving care they deem morally required because they are hierarchically constrained by the orders of a physician. Moral distress has been much discussed in nursing ethics, but is almost entirely absent from broader bioethics syllabi and conversations. This paper examines moral distress through a lens of feminist care ethics. In doing so, it draws lessons that apply very broadly throughout professional ethics.Priest, Maura. Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm2019, The American Journal of Bioethics. 19 (2): 45-59.-
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Added by: Chris Blake-TurnerAbstract:
In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.Comment (from this Blueprint): Priest argues that the state should provide puberty-blocking treatment (PBT) for trans youth, even if their parents are not supportive. Priest’s argument is important partly because it avoids the issue of whether adolescents and children can give properly informed consent. This is a point that some of Priest’s critics seem to have missed (see, for example, Laidlaw et al. 2019. “The Right to Best Care for Children Does Not Include the Right to Medical Transition”, and Harris et al. 2019. “Decision Making and the Long-Term Impact of Puberty Blockade in Transgender Children”). Priest’s conclusion is founded instead on a principle of harm avoidance.Purdy, Laura. Are Pregnant Women Fetal Containers?1990, Bioethics 4(4): 273–291.-
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Added by: Carl Fox
Content: Purdy offers a strong argument against overriding the decisions of pregnant women and tries to reconcile the significance of the dependence of the fetus on the mother with the mother's right to control her own body.Comment : Very useful as introductory or further reading on reproductive rights and/or abortion.Ray, Keisha. It’s Time for a Black Bioethics2021, The American Journal of Bioethics. 21(2): 38–40.-
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Added by: Chris Blake-TurnerAbstract:
There are some long-standing social issues that imperil Black Americans' relationship with health and healthcare. These issues include racial disparities in health outcomes (Barr 2014), provider bias and racism lessening their access to quality care (Sabin et al. 2009), disproportionate police killings (DeGue, Fowler, and Calkins 2016), and white supremacy and racism which encourage poor health (Williams and Mohammed 2013). Bioethics, comprised of humanities, legal, science, and medical scholars committed to ethical reasoning is prima facie well suited to address these problems and influence solutions in the form of policy and education. Bioethics, however, so far has shown only a minimal commitment to Black racial justice.Comment (from this Blueprint): In this short, seminal piece, Keisha Ray argues that bioethics needs to address issues of health and well-being of Black individuals. She applies Beauchamp and Childress’s famous four principles of bioethics to a particular issue: the disproportionate maternal mortality rate of Black women in the United States. Ray argues bioethics must incorporate the lens of Black bioethics, if the discipline is to remain relevant.Rhodes, Rosamond. The professional responsibilities of medicine2007, In Rosamond Rhodes, Leslie Francis & Anita Silvers (eds.), The Blackwell Guide to Medical Ethics. Blackwell.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Publisher's Note: The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policyRoberts, Melinda A.. The Nonidentity Problem2013, E. N. Zalta (ed.), Stanford encyclopedia of philosophy [electronic resource]-
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Added by: Simon Fokt
Introduction: The nonidentity problem focuses on the obligations we think we have in respect of people who, by our own acts, are caused both to exist and to have existences that are, though worth having, unavoidably flawed – existences, that is, that are flawed if those people are ever to have them at all. If a person’s existence is unavoidably flawed, then the agent’s only alternatives to bringing that person into the flawed existence are to bring no one into existence at all or to bring a different person – a nonidentical but better off person – into existence in place of the person whose existence is flawed. If the existence is worth having and no one else’s interests are at stake, it is unclear on what ground morality would insist that the choice to bring the one person into the flawed existence is morally wrong. And yet at the same time – as we shall see – it seems that in some cases that choice clearly is morally wrong. The nonidentity problem is the problem of resolving this apparent paradox. The problem raises the question whether the (usually significant) good that an agent confers along with existence counterbalances the (usually limited) bad that an agent confers along with any unavoidably flawed existence in such a way that our existence-inducing act (usually) will be deemed permissible. And if it isn’t – if we think instead that obligations are left unsatisfied despite the good that comes with existence – is the moral of the story that moral obligation extends beyond what we must do for people? If we agree, in other words, that it is our obligation to create additional good, is it enough that we create additional good for each and every existing and future person? Or does the nonidentity problem show that our focus should instead be on creating additional good for the universe? As we query how to evaluate existence-inducing acts for their moral permissibility – as well as outcomes or possible futures or worlds, for their moral betterness against still other worlds – we find that some of our most deeply held intuitions regarding the nature and structure of morality are thrown into doubt.Comment : This text offers a comprehensive introduction to the nonidentity problem and lists several illustrative thought experiments and examples used in the literature. It is a very helpful introductory or further reading for any topic which touches on the nonidentity problem.Can’t find it?Contribute the texts you think should be here and we’ll add them soon!
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