Campbell, Alastair V.; Gillett, Grant; Jones, Gareth. Medical Ethics. 4.ed. Melbourne, Australia: Oxford University Press, 2005. 312p. ISBN 019-558-487-2   W50 C187m   2005 4.ed.

Contents

The Authors, xi

Preface, xii

PART I: Foundations

1 Theories of Medical Ethics, 2

 - Introduction, 2

 - Some historical backgroud, 2

 - Codes of conduct, 4

 - Utilitarian theories, 5

 - Virtue ethics, 8

 - A professional ethic, 9

 - Respect for persons, 10

 - A worthwhile life, 11

 - Some principles, 11

 -- Non-maleficence/beneficence, 12

 -- Autonomy, 12

 -- Professional integrity, 13

 -- Justice, 13

 - Filling out the picture, 14

 - An illustration, 16

 - Summary and conclusions, 18

2 The Healing Ethos, 20

 - Introduction, 20

 - The doctor-patient relationship, 21

 - Information and consent, 23

 - Confidentiality, 26

 - Truthfulness, 26

 - Collegial relationships, 30

 - Conclusion, 32

3 Health Care Ethics in Diverse Cultures, 34

 - Cultural tensions in healthcare, 34

 - New Zealand biculturalism, 36

 - Is there hope for transcultural rapprochement?, 40

 - A possible basis for ethics, 43

 - History and transcultural ethics, 45

4 The Human Body, 49

 - Introduction, 49

 - Obtaining bodies for dissection, 50

 -- Historical developments in the United Kingdom and New Zealand, 50

 -- Current legislation in the United Kingdom and New Zealand, 51

 -- Persons and bodies, 52

 -- Use of unclaimed bodies, 54

 - Cadavers in the dissecting room, 56

 -- Perceptions of the cadaver, 56

 -- Students'experience of dissection, 59

 - Post-mortem examinations, 61

 -- Post-mortems and consent, 61

 -- Ethical perspectives, 63

 - Archival human material, 65

 - Use of biopsies from surgical operations, 67

 - Can the dead body be abused?, 68

 -- The public display of dead bodies, 68

 -- Teaching on the newly dead, 69

 -- Research on the clinically dead, 71

PART II: Clinical Ethics

5 Genetic Dilemmas, 74

 - Introduction, 74

 - Clinical illustrations, 75

 - Somatic cell gene therapy, 76

 -- Responses to somatic cell gene therapy, 77

 - Germ line gene therapy, 79

 -- Negative and positive eugenics, 79

 - Cloning, 80

 -- Why clone a humam being?, 82

 -- Reasons against reproductive cloning, 83

 -- Human therapeutic cloning, 84

 - Genetic screening, 84

 -- Principles of genetic screening programs, 85

 -- Genetic screening for susceptibility to disease, 87

 - Patenting of human genes, 88

 - Human Genome Project, 90

 - Biobanking, 93

 - Human genes in other organisms, 95

 - General ethical questions, 97

6 Issues before Birth, 99

 - Introduction, 99

 - Biological definitions, 99

 -- Embryo and foetus, 99

 -- Fertilisation and pre-embryonic stage, 100

 - Personhood of the embryo and foetus, 101

 -- Embryos/foetuses are persons, 102

 -- Embryos/foetuses are non-persons, 104

 -- Embryos/foetuses are potential persons, 105

 - Research on embryos, 106

 -- Sources of embryos for research, 107

 -- General issues and principles, 107

 -- Embryo research as related to infertility, 109

 -- Embryo research as related to the prevention of hereditary diseases, 111

 -- Embryo research directed towards curing human disease, 113

 - Foetal research, 115

 - Abortion, 116

7 Birth and Beyond, 118

 - Birth rights, 118

 - Dilemmas after birth, 119

 - Parental decisions regarding treatment options, 123

 - Child abuse and child protection, 125

 - The 'best interests of the child' criterion, 127

 - Resouce allocation and at-risk children, 128

 - Children as research participants, 129

8 Organ and Tissue Transplantation, 132

 - Introduction, 132

 - Consent in cadaveric organ donation, 133

 - Organs fron living donors, 136

 - Use of anencephalics in transplantation, 137

 - Foetal neural transplantation, 139

 - Xenotransplantation, 142

 -- Arguments against xenotransplantation, 142

 -- Animal welfare, 144

 - Tissue transplantion, 145

 -- Foetal motherhood, 145

9 The Challenge of AIDS, 147

 - Ethical responses to AIDS, 147

 -- Informed consent and HIV testing, 148

 -- Public health issues, 148

 -- HIV, AIDS, and societal injustice, 150

 -- AIDS in the Third World, 151

 -- HIV tests and conflicts between patients, 152

 -- The doctor-patient relationship, 153

 - Confidentiality, 154

 - A terminal illness, 156

10 Ethical Issues in Psychiatry, 159

 - Introduction, 159

 - Diagnosis, classification, and stigmatisation, 159

 -- When is a syndrome not a syndrome?, 161

 - Clinicians, patients, and therapeutic relationships, 164

 - Compulsory treatment, 168

 - Alcohol and drug addiction, 169

 - Psychosurgery and electroconvulsive therapy, 170

 - Confidentiality, 173

 - Suicide and psychiatric illness, 174

 - Conclusion, 176

11 Disability and Ethics, 177

 - Introduction, 177

 - Infantilisation, 178

 - The social amplification of disability, 179

 - Eugenics and selective abortion, 180

 - Cultural genocide and euthanasia, 181

 - Sexuality and sexual choices, 182

 - Narratives and silences of disabilities, 183

 - The silences imposed by medicine, 184

12 Aging, Dementia, and Mortality, 185

 - Introduction, 185

 - Neurobiology of aging, 185

 - Approaches to aging, 186

 -- The blessing of mortality, 186

 -- Resources, the elderly, and quality adjusted life years (QALYs), 187

 -- Problems of aging, 188

 -- Independence and the impairments of age, 191

 - Neurobiology of Alzheimer's disease, 192

 - Approaches to Alzheimer's disease, 193

 -- The personal experience of dementia, 193

 -- Personhood and dementia, 195

 -- Appropriate care in Alzheimer's disease, 196

 -- Would the demented be better off dead?, 198

 -- Genetic testing and counselling, 199

 - Brain death, 200

 -- Significance of the brain, 200

 -- Definitions of death and brain death, 201

 -- Whole brain definition of death, 202

 -- Higher brain definition of death, 203

13 Ending Human Lives, 205

 - Introduction, 205

 - The death of a person, 205

 - Facing death, 209

 - Suicide, 211

 - Euthanasia, 213

PART III: Medicine and Society

14 Research Ethics, 222

 - Introduction, 222

 - Scientific validity, 224

 - Risks and benefits, 225

 - Information and consent, 226

 - Procedures, 229

 -- Independence and impartiality, 229

 -- Due process, 230

 -- Accountability, 231

 - International research ethics, 232

 - The use of animals in medical research, 233

15 Trying New and Unusual Things, 237

 - Introduction, 237

 - Medicine and rationality of science, 238

 - Limitations of medical scientific discourse, 239

 - Values intrinsic to medicine, 241

 - Surgical innovation, 242

 - Other systems of healing, 246

 - A clinical modus operandi, 249

 - Contemporary orthodox medical science, 251

 - Conclusion, 252

16 Justice and Health Care, 254

 - Introduction, 254

 - The paradox of health care, 255

 - Equity and theories of justice, 256

 - Arbitrating between needs, 258

 - Maximising the minimum, 261

 - A basic minimum?, 262

 - State-funded care versus private practice, 264

 - Conclusion, 266

17 Law, Ethics, and Medicine, 268

 - Introduction, 268

 - Ethics and the law, 269

 - Professional requirements on doctors and others, 271

 - Health care workers and criminal law, 273

 - Civil disputes, 274

 - Conclusion, 276

Appendix 1 The Hippocratic Oath, 277

Appendix 2 The Geneva Convention Code of Medical Ethics, 278

Appendix 3 Council for International Organizations of Medical Sciences (CIOMS) International Guiding Principles for Biomedical Research Involving Animals, June 1984, 279

Appendix 4 World Medical Association Declaration of Helsinki, 281

References, 286

Index, 306