Biomedical Ethics And Fetal Therapy

“Over the last two decades, medical researchers have become more comfortable with the idea that serious attention must be given to ethical issues when the tests of new technologies are being designed. They have come to see that experimental trials must meet certain standards, not only of scientific rigour, but also of moral acceptability.” (Introduction) Presented by an international group of experts, the eight essays included in this volume evaluate the new technologies in fetal care and also wrestle with the new problems, often moral ones, that have accompanied techonological advancement. The opening chapters review state-of-the-art ultrasound imaging and molecular genetics and focus on the new patient—the fetus. From here, the efficacy of fetal therapy, the problem of assessing long-term viability, the ethical issues involved in both clinical practice and medical research, and the legal rights of the new patients and their parents are examined. The final chapter “Are Fetuses Becoming Children?” brings a fresh philosophical perspective to the question of a fetus’s status and rights.

Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of ‘fetal patient’ against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of ‘fetal patient’ from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.

This is the second volume of Biomedical Ethics Reviews, a series of texts designed to review and update the literature on issues of central importance in bioethics today. Five topics are dis cussed in the present volume. Section I, Public Policy andRe search with Human Subjects, reviews the history of the moral issues involved in the history of research with human subjects, and confronts most of the major legal and moral problems involving research on human subjects. Questions addressed in this section range from those concerning informed and proxy consent to those dealing with the adequacy of monitoring hu man research via institutional review boards (IRBs). Section II deals with a second broad topic in bioethics, The Right to Health Care in a Democratic Society. Here the concern not merely that of determining whether there is a right to is health care, but also, if there is such a right, how it ought best be understood and implemented. To answer questions such as these, we learn that one must distinguish legal from moral rights, assess the merits of various theories of rights, clarify the relationship between rights and duties, and attempt to deter mine a just method for the distribution of health care. Advances in medical technology often pose new legal and moral problems for legislators and health care practitioners.

This book offers a comprehensive and clinically practical approach to ethics in the everyday practice of obstetrics and gynecology. The topics the authors address include: contraception, abortion, selective termination of multifetal pregnancies, gynecologic cancer, in vitro fertilization, surrogacy, prenatal diagnosis, fetal therapy, cephalocentisis, prematurity, HIV infection, and court ordered cesarean delivery. The issues involved in making decisions in many of these areas are a source of conflict, and lead to crisis between the physician and patient. One of the book's strengths is its emphasis on prevention and, if prevention fails, management, of the conflicts and crises which arise in these areas of medicine. The authors develop their preventative and management strategies on the basis of a framework for bioethics in the clinical setting. This framework is rigorously established and defended. The authors argue that four virtues -- self effacement, self sacrifice, compassion, and integrity -- generate the physician's obligation to protect and promote the patient's interest. They then identify the three types of patient's interests -- social role interests, subjective interests, and deliberative interests -- and they reinterpret the ethical principles of beneficence and respect for autonomy in terms of these. The concept of the fetus as patient, the physician's obligation to third parties, and the moral standing of fathers and family members are also addressed. The implications of their argument sets the stage for the discussions of prevention and management in the remaining sections of the book. Ethics in Obstetrics and Gynecology is a unique addition to the literature in both biomedical ethics and obstetrics and gynecology. It demonstrates that ethics should be regarded as an essential part of obstetrics and gynecology, and that clinical practice is incomplete without i

In the past few years, an increasing number of colleges and universities have added courses in biomedical ethics to their curricula. To some extent, these additions serve to satisfy student demands for "relevance. " But it is also true that such changes reflect a deepening desire on the part of the academic community to deal effectively with a host of problems which must be solved if we are to have a health-care delivery system which is efficient, humane, and just. To a large degree, these problems are the unique result of both rapidly changing moral values and dramatic advances in biomedical technology. The past decade has witnessed sudden and conspicuous controversy over the morality and legality of new practices relating to abortion, therapy for the mentally ill, experimentation using human subjects, forms of genetic interven tion, and euthanasia. Malpractice suits abound, and astronomical fees for malpractice insurance threaten the very possibility of medical and health-care practice. Without the backing of a clear moral consensus, the law is frequently forced into resolving these conflicts only to see the moral issues involved still hotly debated and the validity of the existing law further questioned. Take abortion, for example. Rather than settling the legal issue, the Supreme Court's original abortion decision in Roe v. Wade (1973), seems only to have spurred further legal debate. And of course, whether or not abortion is a mo rally ac ceptable procedure is still the subject of heated dispute.

This title was first published in 2000: This third volume of proceedings of the European Network for Biomedical Ethics focuses on the ethical issues surrounding the debates on reproductive medicine and genetics in human procreation. Central issues include procreation and parenthood, moral protection of the human embryo and foetus, autonomy and recognition, social implications, moral reasoning in applied ethics, legal regulations of assisted procreation, genetic diagnosis and gene therapy. The legal regulation paper evaluates the central laws and guidelines of European countries.

This book addresses the ethical problems in maternal-fetal medicine which impact directly on clinical practice.