George P. Smith, II is a leading figure in the world of medical law and ethics. During his long career he has addressed some of the most important issues in bioethics and has contributed much original thought to the debates in this field. This book celebrates his contribution bringing together his key writings in bioethics. The chapters include previously published material, however, the pieces have been substantially updated to include more recent developments and rewritten drawing out the themes and strands which have run through Professor Smith's thinking over the past fifty years. The book covers topics including: human rights and medical law; the allocation of resources and distributive justice; ethical relativism; science and religion; and public health emergencies. In doing so it offers an excellent overview of the current bioethical issues in medical law in light of recent and ongoing technological developments in medicine. "This collection of essays by one of the world's leading medical lawyers is academic research of the highest quality. With an enviable clarity of thought and force of argument, Professor Smith tackles some of the major issues facing medicine and law today. It is a tour de force by an academic at the height of his powers." Professor Jonathan Herring, University of Oxford.
Increasingly, legislators at the state and federal levels of government are forced to evaluate and act upon the unique problems presented by an aging American public. A domino effect has occurred, evoking concern in educational circles to deal with the varied, complex issues associated with the "new" gerontology. This expanded focus brings in not only mental and public health delivery issues, but reaches and impacts on the social sciences, ethics, law and medicine as well as public policy. In response to these matters, Legal and Healthcare Ethics for the Elderly provides a balanced analytical presentation of the complicated socio-legal, medico-ethical and political perspectives which interact with gerontology as a field of study. In a straightforward and unambiguous style, it covers information on access and financing healthcare, the ethics of rationing healthcare and the inevitable link to the quality of life, guardianship issues in a nursing home setting, informed consent, living wills and durable powers of attorney, elder abuse, and death with dignity. The economics of care giving is charted and directed by the sometimes harsh realities of the marketplace. Thus, the various philosophical and ethical dilemmas which confront the process of aging are examined here both from a micro- and from a macro-economic perspective. This book exemplifies that it is vitally important to be educated now, to be prepared for the future and thereby make informed decisions - for both ourselves and our loved ones.
The eight chapters within this volume are structured around an exploration of the fundamental issues in the field of biomedical human rights: dignity and autonomy in not only procreative liberties but throughout the complete cycle of life and death, the freedom of scientific inquiry into the new biotechnological methods of collaborative reproduction, the right to genetic integrity at birth and throughout life, and the equitable right to health or access to health care benefits during life and old age. All these central issues are tested, of necessity, but utilitarian principles which, in turn, force the templates for decision making, evaluate the gravity of harm deriving from a particular human right and its recognition and enforcement measured against the utility of the social, economic, or cultural good accruing from recognition of such a right in the first instance. Ultimately, cultural relativism will be seen - more often than universality - as the determinative point of balance. This volume not only informs the ongoing debate on the role of human rights in biomedicine, but will also provide enlightened responses to the troublesome issues presented in this new age of biotechnology.
Improvement of man's genetic endowment by direct ac tions aimed at striving for the positive propagation of those with a superior genetic profile (an element of which is commonly recognized as a high intelligence quotient) or-conversely-delimitation of those with negative genetic inheritance has always remained a pri mary concern of the geneticist and the social engineer. Genetic integrity, eugenic advancement, and a strong genetic pool designed to eliminate illness and suffering have been the benchmarks of the "Genetic Movement" and the challenge of Orwell's Nineteen Eighty-Four. If the quality of life can in some way be either im proved or advanced by use of the law, then this policy must be developed and pursued. No longer does the Dostoyevskian quest to give life meaning through suf fering become an inescapable given. By and through the development and application of new scientific advances in the field of genetics (and especially genetic engi neering), the real potential exists to prevent, to a very vii Preface viii real extent, most human suffering before it ever mani fests itself in or through life. Freedom to undertake re search in the exciting and fertile frontiers of the "New Biology" and to master the Genetic Code must be nur tured and maintained. The search for the truth inevi tably prevents intellectual, social, and economic stag nation, as well as-ideally-frees all from anxiety and fright. Yet, there is a very real potential for this quest to confuse and confound.
Dignity is seen, commonly, as an ethical obligation owed to human persons. The dimensions of this obligation are subject to wide discussion and defy universal agreement. Dignity is seen, commonly, as an ethical obligation owed to human persons. Dignity as a Human Right? examines dignity within the prism of death, and more particularly, its humane and dignified management. Although there is no domestic or international right to die with dignity, within the right to life should, arguably, be a right to dignity and self-determination especially at its end-stage; for, a powerful interface exists between the right to human dignity and the very right to life, to love and humanity as well as compassion at its conclusion. Legislative efforts--nationally and internationally--have begun to recognize a right to die with dignity when a condition of medical futility exists. There are presently five states and the District of Columbia, together with a judicial interpretation from the Montana Supreme Court, which recognize death assistance for the terminally ill. Internationally, Canada, Belgium, the Netherlands, and Switzerland are seen as leaders in this recognition. The United Nations has played a significant role in framing end-of-life decision making within the ambit of human rights protection. The UN Charter states unequivocally that the dignity and worth of the human person must be protected and safeguarded. Similarly, among other instruments, the Universal Declaration on Human Rights acknowledges that all human beings are born free and equal in dignity and rights.
Religion is a dominant force in the lives of many Americans. It animates, challenges, directs and shapes, as well, the legal, political, and scientific agendas of the new Age of Biotechnology. In a very real way, religion, biomedical technology and law are - epistemologically - different. Yet, they are equal vectors of force in defining reality and approaching an understanding of it. Indeed, all three share a synergetic relationship, for they seek to understand and improve the human condition. This book strikes a rich balance between thorough analysis (in the body), anchored in sound references to religion, law and medical scientific analysis, and a strong scholarly direction in the end notes. It presents new insights into the decision-making processes of the new Age of Biotechnology and shows how religion, law and medical science interact in shaping, directing and informing the political processes. This volume will be of interest to both scholars and practitioners in the fields of religion and theology, philosophy, ethics, (family) law, science, medicine, political science and public policy, and gender studies. It will serve as a reference source and can be used in graduate and undergraduate courses in law, medicine and religion.
Smith has packed an incredible amount of information into this relatively short and clearly written book. His erudition is unquestionable, and his knowledge of current trends in medical technology and the ethical issues surrounding them is obvious on every page. P. Jenkins, Choice George P. Smith is one of the world s leading experts on the legal and ethical issues raised by modern medicine. His book is a wide-ranging and deeply informed and considered analysis of those issues, with particular emphasis on the inequality with which the benefits of modern medicine are bestowed on the sick. Knowledgeable as well about the technical aspects of the biomedical revolution, Smith writes with insight and authority, and offers a perspective that will influence the policy debates. Richard A. Posner, United States Court of Appeals for the Seventh Circuit and University of Chicago Law School, US While much has been written about the various issues addressed in this book genetics, cloning, informed consent, organ donation Smith s book moves beyond traditional legal analysis, tying these issues together by examining them through the lens of distributive justice. He thus provides the reader with a unique and valuable perspective on this important area. Distributive Justice and the New Medicine will be of interest to all those interested in health law and bioethics and in particular for those interested in distributive justice. Belinda Bennett, Journal of Law, Social Justice and Global Development Professor George P. Smith s Distributive Justice and the New Medicine is a major new work by one of the world s leading medical lawyers. This book brings important new insights into the complex area of rationing health care resources and should be read by anyone interested in seeking to create a just society. Jonathan Herring, Exeter College, University of Oxford, UK Is the advancement of scientific knowledge and the development of biomedical technologies known as the New Medicine desirable? George P. Smith asks this fundamental question while also confronting the distribution of these scarce medical resources. Law, economics, medical science, philosophy and ethics all coalesce in this discussion of how to structure normative standards of conduct that will improve the quality of human life. The author begins by examining various economic constructs as aids for achieving a fair and equitable delivery of health care services. He then assesses their level of practical application and evaluates the costs and benefits to society of pursuing the development and use of the New Medicine . The book ends with a case study of organ and tissue transplantation that illustrates the implementation of distributive justice. The author concludes that as long as clinical medicine maintains its focus on healing and alleviating suffering among patients, a point of equilibrium will be reached that advances the common good. This timely and compelling exploration will be a must-read for scholars, researchers, policymakers and all those interested in advances in medical technology and the issues surrounding access to health care.
With the 13th edition, Wintrobe’s Clinical Hematology once again bridges the gap between the clinical practice of hematology and the basic foundations of science. Broken down into eight parts, this book provides readers with a comprehensive overview of: Laboratory Hematology, The Normal Hematologic System, Transfusion Medicine, Disorders of Red Cells, Hemostasis and Coagulation; Benign Disorders of Leukocytes, The Spleen and/or Immunoglobulins; Hematologic Malignancies, and Transplantation. Within these sections, there is a heavy focus on the morphological exam of the peripheral blood smear, bone marrow, lymph nodes, and other tissues. With the knowledge about gene therapy and immunotherapy expanding, new, up-to-date information about the process and application of these therapies is included. Likewise, the editors have completely revised material on stem cell transplantation in regards to both malignant and benign disorders, graft versus host disease, and the importance of long-term follow-up of transplantation survivors.
During the past ten years, several theories have been proposed on the origin of the diversity of antibodies. George P. Smith presents a critical study of these theories in this detailed treatment of immunological problems from the point of view of molecular genetics. Mr. Smith uses a new and simplifying approach to this long-standing controversy. By a comprehensive computerized analysis of antibody amino acid sequences (particularly the myeloma proteins), the author traces their evolution and matches his results against the expectations of the various theories of diversity. He discusses at length the other types of evidence as well. Mr. Smith also deals with the clonal specialization of cells to produce a single antibody, and the relationship of this specialization to the somatic joining of antibody half-genes, which is one of the immune system's most important peculiarities. Introductory material is provided to make this work understandable to molecular geneticists not versed in immunology and to immunologists not versed in molecular genetics. This is a timely book offering a succinct and coherent summary of the various lines of evidence in a confused and controversial field.
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