David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making. Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man's best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers. The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical pract

This title was first published in 2001: Ethical thinking about medical decision-making has roots deep in history. This collection of contemporary essays by leading international scholars traces the development of modern bioethics and explores the theory and current issues surrounding this widely contested field.

This book clarifies the meaning of the most important and pervasive concepts and tools in bioethical argumentation (principles, values, dignity, rights, duties, deliberation, prudence) and assesses the methodological suitability of the main methods for clinical decision-making and argumentation. The first part of the book is devoted to the most developed or promising approaches regarding bioethical argumentation, namely those based on principles, values and human rights. The authors then continue to deal with the contributions and shortcomings of these approaches and suggest further developments by means of substantive and procedural elements and concepts from practical philosophy, normative systems theory, theory of action, human rights and legal argumentation. Furthermore, new models of biomedical and health care decision-making, which overcome the aforementioned criticism and stress the relevance of the argumentative responsibility, are included.

"An excellent resource for entry-level courses on bioethics for health care practitioners, law students, and physicians." -- Choice "Dworkin's provocative arguments... will challenge readers who have come to accept the law's intrusion as a necessary response to biomedical advances." -- New England Journal of Medicine "Important and refreshing. Dworkin's conclusions regarding the limited role of law (and especially legislation) may come as a surprise to many.... When popular and political views are almost evenly divided, looking to legislation for a solution is a mistake." -- Walter Wadlington The ethical and social dilemmas associated with abortion, sterilization, assisted reproduction, genetics, death and dying, and biomedical research have led many to turn to the legal system for solutions. Rogert Dworkin argues that resort to law often overlooks the limitations of legal institutions, and he suggests a more limited use of the legal system will produce more effective resolution of bioethical dilemmas.

What is 'legal' about bioethics? What are the ideas and artefacts that bioethics encompasses, and how are they related to law? What is the role of law in bioethics? In this work, Calvin Ho attempts to address these questions in the context of the governance of human pluripotent stem cell research. In essence, he argues that the hybridization of law, through processes, devices and techniques of juridification, has helped to constitute bioethics as a public sphere and an emergent civic epistemology.Drawing on his multi-sited ethnographic fieldwork and on Actor-Network-Theory, Ho explains how the law has, through bioethics, contributed to the scientific and public understanding of human pluripotent stem cell research and its artefacts, particularly the embryo and human-animal combinations. Although the focus of his work is on bioethical developments in Singapore over a period of more than 15 years, parallel developments in key jurisdictions (especially the United States of America and the United Kingdom) and in international science policy are also evaluated. It is through appreciating how it has progressed that bioethics will be better able to engage with future challenges presented by advances in human embryo research and gene editing techniques, among others.

This groundbreaking volume is the first to analyze how and to what extent bioethics considerations influence today's judges. Previous books have attended to the law that governs bioethics problems, but this is the first to examine when and how bioethical issues impact judicial reasoning and decision-making. The volume examines the cutting-edge of the relationship of bioethics to law, and explores how law receives, assesses, and uses bioethics.