This book arises from a two-fold conviction. The first is that autonomy, despite recent critiques about its importance in bioethics and philosophy of medicine, and the traditional resistance of medicine to its "intrusion" into the doctor-patient relation, is a fundamental building block of an individual's identity and mechanisms for dealing with illness, disease, and incapacity. As such it is an essential component in the health care professional's armamentarium employed to bring about healing. Furthennore, it functions in a similar way to assist the health professional in his or her relations to the sick and injured. The second conviction follows from the fITst. Autonomy is far more complex than appears from the philosophical use of the concept. In this conviction we join those who have criticized the over-reliance on autonomy in modem, secular bioethics originating in the United States, but gaining ascendancy in other cultures. This critique relies on appeals to the richer contexts of persons' lives. Elsewhere the contemporary critique of autonomy appears in a variety of alternative ethical models like narrative ethics, casuist ethics, and contextualism. Indeed, postmodern criticism of all bioethics argues that there is no defensible foundation for claims that one ought to respect autonomy or any other principle as a way of ensuring that one is ethical.

Alasdair Maclean analyses the ethical basis for consent to medical treatment, providing both an extensive reconsideration of the ethical issues and a detailed examination of English law. Importantly, the analysis is given a context by situating consent at the centre of the healthcare professional-patient relationship. This allows the development of a relational model that balances the agency of the two parties with their obligations that arise from that relationship. That relational model is then used to critique the current legal regulation of consent. To conclude, Alasdair Maclean considers the future development of the law and contrasts the model of relational consent with Neil Manson and Onora O'Neill's recent proposal for a model of genuine consent.

Does reading poetry make you a better clinician?Can euthanasia be understood in terms of the meaning of a life?What is the moral and existential significance of life-threatening experiences? Australian surgeon, poet, philosopher and humanist, Miles Little addresses these and other fascinating questions in this collection of papers.Miles Little is one of the most original and engaging voices in contemporary medical ethics and philosophy. He ranges across the sciences and the humanities, creating hybrid fields of inquiry ("ethonomics"), interrogating orthodoxies and engaging different fields of human knowledge and experience.The papers in this collection were chosen by his readers, who also engage here with Miles Little's work in a short commentary that follows each paper. The range of the commentators reflects the breadth of Little's appeal and influence: academics and clinicians, philosophers and ethicists, novelists, public health practitioners and cancer survivors - each reflects, agrees or disagrees.Like Little's work itself, this Reader is an open and unfolding dialogue that includes many different perspectives.Commentators include: Murray Bail, Robin Downie, Nancy Dubler, Stan Goulston, Jill Gordon, Paul Komesaroff, Steve Leeder, Paul McNeill , Gavin Mooney and Bernadette Tobin

In its first edition, Principles of Clinical Medicine for Space Flight established itself as the authoritative reference on the contemporary knowledge base of space medicine and standards of care for space flyers. It received excellent notices and is used in the curricula of civilian and military training programs and used as a source of questions for the Aerospace Medicine Certifying Examination under the American Board of Preventive Medicine. In the intervening few years, the continuous manning of the International Space Station has both strengthened existing knowledge and uncovered new and significant phenomena related to the human in space. The Second Edition incorporates this information. Gaps in the first edition will be addressed with the addition new and revised chapters. This edition is extensively peer reviewed and represents the most up to date knowledge.

The overall aim of this protocol is to facilitate the translation in clinical practice of the principles of evolving capacity of the child and the right for autonomy and self-determination for adolescent clients. The right to participation is one of the fundamental rights stated in the International Convention of the Rights of the Child. Therefore, all adolescents should not only freely express their views on any decisions regarding their health, but also be able to make autonomous decisions about their health taking into account their capacity of doing so. In many countries, minor adolescents can be considered legally competent to make autonomous decisions, as long as, in a given situation, their health care providers (HCP) deem them so. However, the evaluation of decision-making capacity is far from being a straightforward issue for HCP in the field. Many factors are to be taken into consideration such as the developmental perspective, the parents/guardians role, as well as important legal and ethical issues. In this perspective, the purpose of this work was to develop a practical tool to help HCP in the process of assessing and supporting the adolescent capacity for autonomous decision-making in a health care setting. The guidance is designed to be used by a wide range of HCPs (e.g., doctors, nurses, and allied health professionals) who work adolescents across a range of different settings (e.g., community, primary and tertiary care settings).

This textbook develops the issue of ethics to a philosophical level complex enough to be applicable to students of philosophy and applied ethics courses. It is the first book to address clinical problems from a classical perspective.

This is an original book on the philosophy of medicine. It considers philosophy of medicine as a subdiscipline of philosophy of science. This volume is grounded on an epistemological bottom-up account that arises from the clinical situation, the epidemiologic, and the resulting public health account. It is not a review of the literature, and it is not intended to frame the debates, or to analyze and compare the various number of viewpoints. Medicine is the human activity, which begins by a linguistic act that identifies the negative norms of health: it begins with a first distinction that splits biological processes into three conventional parts, normal, abnormal and pathologic. Neither of them is a natural kind. Being abnormal is intrinsically bad and admits of degrees, while being pathologic is dichotomous. Being normal is factitious and counterfactual much the same as frictionless planes in physics. Leaving apart the ethical aspects, this book endeavors to uncover the implicit conceptual network, the chief junctures of medicine, should they be found, and their articulations with clinical and community medicine. It results that medicine is pervaded with dichotomous concepts such as scientific vs pragmatic discourse, function and malfunction, abnormal and pathologic, needs and wants, causation and explanation, clinical vs community-oriented care, physical vs psychiatric diseases, mental illness vs deviancy, and so on. Medical thinking has two dimensions intrinsically interweaved, namely a constant amalgam and admixture of biological and normative aspects, so that this essential hybrid nature of the grammar of medicine endorses opposite approaches, naturalistic or normativist, biological or value-laden, realist or instrumental, reductionist or holistic, phenomenological or analytic.

This issue Obstetrics and Gynecology Clinics examines Medical Complications in Pregnancy. Guest Editor Dr. Judith Hibbard has assembled a panel of experts who offer reviews on topics including Preeclampsia, Chronic hypertension, Peripartum cardiomyopathy, Valvular heart disease in pregnancy, Pregestational diabetes, Asthma management, Management of renal disease, Renal transplant recipients and pregnancy, Sickle disease and pregnancy, Thyroid disease, Update on gestational diabetes, Pregnancy after gastric bypass, Thromboprophylaxis in obstetrics, Cholestasis of pregnancy, and Hepatitis: screening and management.