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E-grāmata: Transplantation Ethics: Second Edition

  • Formāts: 352 pages
  • Izdošanas datums: 22-Jan-2015
  • Izdevniecība: Georgetown University Press
  • Valoda: eng
  • ISBN-13: 9781626161696
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  • Formāts: 352 pages
  • Izdošanas datums: 22-Jan-2015
  • Izdevniecība: Georgetown University Press
  • Valoda: eng
  • ISBN-13: 9781626161696
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Although the history of organ transplant has its roots in ancient Christian mythology, it is only in the past fifty years that body parts from a dead person have successfully been procured and transplanted into a living person. After fourteen years, the three main issues that Robert Veatch first outlined in his seminal study Transplantation Ethics still remain: deciding when human beings are dead; deciding when it is ethical to procure organs; and deciding how to allocate organs, once procured.

However, much has changed. Enormous strides have been made in immunosuppression. Alternatives to the donation model are debated much more openly -- living donors are used more widely and hand and face transplants have become more common, raising issues of personal identity. In this second edition of Transplantation Ethics, coauthored by Lainie Friedman Ross, transplant professionals and advocates will find a comprehensive update of this critical work on transplantation policies.

Recenzijas

This is a must-read book for anyone wishing to understand the complexities surrounding organ transplantation. Besdies thoroughness and depth of discussion, one of the many strenghths found throughout this book is the authors' repeated demonstration of the need for metaethical thinking. . . . This book is well researched, broadly reasoned, and offers several proposals for advancement in a multicultural and pluralistic society. . . . I highly recommend this book for those interested in a solid evaluation of most of the relevant issues surrounding death. . . . It is especially suited to the bioethics student, ethics committee member, and those interested in becoming an organ donor. * Ethics & Medicine * Deserves to be the definitive reference on the shelf of transplant professionals interested in ethics and public policy. * Monash Bioethics Review *

Papildus informācija

"Deserves to be the definitive reference on the shelf of transplant professionals interested in ethics and public policy."Monash Bioethics Review * Monash Bioethics Review *
List of Illustrations
xiii
Preface xv
1 Religious and Cultural Perspectives
1(23)
Defining Death and Desecrating the Corpse: Two Preliminary Issues
1(10)
The Two Central Ethical Issues
11(6)
Conclusion
17(1)
Notes
18(6)
2 An Ethical Framework: General Theories of Ethics
24(13)
Religious Ethical Approaches
24(1)
Secular Ethical Approaches
25(7)
Notes
32(5)
PART I DEFINING DEATH
3 The Dead Donor Rule and the Concept of Death
37(15)
The Dead Donor Rule
39(2)
Candidates for a Concept of "Death"
41(4)
The Public Policy Question
45(4)
Notes
49(3)
4 The Whole-Brain Concept of Death
52(12)
The Case for the Whole-Brain Concept
54(1)
Criteria for the Destruction of All Brain Functions
55(5)
Problems with the Whole-Brain Definition: The Alternatives
60(1)
Notes
61(3)
5 The Circulatory, or Somatic, Concept of Death
64(24)
Two Measurements of Death
65(3)
Circulatory Death and Organ Procurement
68(6)
Ways Around Absence of Explicit Consent
74(6)
The DCD Protocols
80(3)
Shewmon's Somatic Concept
83(1)
The Two Definitions of the US President's Council on Bioethics
84(1)
Notes
85(3)
6 The Higher-Brain Concept of Death
88(14)
Which Brain Functions Are Critical?
89(4)
Altered States of Consciousness: A Continuum
93(2)
Measuring the Loss of Higher-Brain Function
95(1)
Ancillary Tests
96(2)
The Legal Status of Death
98(1)
Notes
99(3)
7 The Conscience Clause: How Much Individual Choice Can Our Society Tolerate in Defining Death?
102(21)
The Present State of the Law
103(1)
Concepts, Criteria, and the Role of Value Pluralism
104(4)
Explicit Patient Choice, Substituted Judgment, and Best Interest
108(2)
Limits on the Range of Discretion
110(1)
The Problem of Order: Objections to a Conscience Clause
111(7)
Implementation of a Conscience Clause
118(1)
Conclusion
119(1)
Notes
119(4)
8 Crafting a New Definition-of-Death Law
123(8)
Incorporating the Higher-Brain Notion
123(1)
The Conscience Clause
124(1)
Clarification of the Concept of "Irreversibility"
125(1)
A Proposed New Definition of Death for Public Policy Purposes
126(1)
Conclusion
126(1)
Notes
127(4)
PART II PROCURING ORGANS
9 The Donation Model
131(16)
The Moral Foundation of the Donation Model
132(5)
Variations on the Donation Model
137(6)
The Limits of the Donation Model
143(1)
Notes
144(3)
10 Routine Salvaging and Presumed Consent
147(17)
Routine Salvaging
147(3)
An Opt-Out
150(3)
The Morality of Salvaging
153(1)
Presumed Consent
153(2)
The State of the Law
155(4)
What Is at Stake
159(1)
Notes
160(4)
11 Markets for Organs
164(24)
The World's Experience with Organ Markets
165(9)
The Ethics of a Market for Organs
174(6)
Variations on the Market Model: "Rewarded Gifting"
180(2)
Notes
182(6)
12 Live-Donor Transplants
188(26)
The Living Donor
188(1)
Expanding Living Donors: Paired Live-Donor Exchanges and Variants
189(2)
The Ethics of Live Donation: Two Approaches
191(11)
Exchanges and Chains
202(4)
The Right of Persons to Become Donors
206(3)
Conclusion
209(1)
Notes
210(4)
13 High-Risk Donors
214(17)
The Types of High-Risk Organs
215(6)
Should Transplant Patients Receive High-Risk Organs?
221(1)
Why Do Surgeons Fear High-Risk Organs?
222(2)
A Proposal for a Policy Change
224(2)
Notes
226(5)
14 Xenotransplants: Using Organs from Animals
231(20)
The History of Xenotransplantation
232(2)
Special Ethical Problems Raised by Xenotransplantation
234(12)
Conclusion
246(1)
Notes
247(4)
15 The Media's Impact on Transplants and Directed Donation
251(20)
Direct Media Solicitation by Individuals for a Deceased Donor
252(3)
The Media and Living Directed Donation
255(4)
Living versus Deceased Directed Media Appeals
259(1)
Limits to the Media
260(3)
The Media and Transplant Programs
263(1)
Conclusion
264(1)
Notes
264(7)
PART III ALLOCATING ORGANS
16 The Roles of the Clinician and the Public
271(13)
The Clinician and Allocation
271(2)
Allocation as a Moral Rather Than Technical Matter
273(5)
The Role of the Public in Allocation
278(2)
Conclusion
280(2)
Notes
282(2)
17 A General Moral Theory of Organ Allocation
284(22)
Social and Medical Utility
285(6)
The Issue of Justice
291(7)
Respect for Persons
298(3)
Conclusion
301(1)
Notes
302(4)
18 Voluntary Risks and Allocation: Does the Alcoholic Deserve a New Liver?
306(15)
The Theory of Voluntary Health-Risky Behavior
306(6)
Alcohol and Liver Transplants
312(3)
The Role of a History of Alcoholism in Allocation Policy: Four Options
315(2)
Other Voluntary Behaviors
317(2)
Notes
319(2)
19 Multi-Organ, Split-Organ, and Repeat Transplants
321(13)
Multi-Organ Transplants
322(3)
Repeat Transplants
325(4)
Splitting Organs and Combining Organs
329(2)
Notes
331(3)
20 The Role of Age in Allocation
334(21)
The Moral Norms for Allocation
334(5)
Allocation to Minors
339(1)
Allocation to Older Persons
340(1)
New Formulas for Taking Age into Account
341(10)
Over-a-Lifetime Need versus Present Need
351(1)
Notes
351(4)
21 The Role of Status: The Cases of Mickey Mantle, Robert Casey, Steve Jobs, and Dick Cheney
355(12)
Mickey Mantle and Liver Priority
355(4)
Governor Casey's Case
359(1)
Steve Jobs's Liver
360(1)
Dick Cheney's Heart
361(1)
Social Worth versus Social Status
362(3)
Notes
365(2)
22 Geography and Other Causes of Allocation Disparities
367(26)
The Role of Geography in Allocation
368(5)
The Reasons for Local Priority
373(3)
The Demand for a National List
376(4)
The Ethics of the Conflict over Geography
380(3)
Did the Final Rule Achieve Equity?
383(4)
Notes
387(6)
23 Socially Directed Donation: Restricting Donation by Social Group
393(16)
Two Examples of Socially Directed Donation
393(2)
The Concept of Socially Directed Donation
395(1)
Moral Arguments about Socially Directed Donation
395(4)
The Inadequate Case for the Maximin
399(2)
Egalitarian Justice as a Prima Facie Principle
401(3)
The True Egalitarian Alternative
404(1)
Conclusion
405(1)
Notes
405(4)
24 Elective Organ Transplantation
409(8)
If Liver Grafts Were Not Scarce
410(1)
Elective Liver Transplantation
410(3)
Do Numbers of Organs Count?
413(1)
Domino Liver
414(1)
Conclusion
415(1)
Notes
415(2)
25 Vascularized Composite Allografts: Hand, Face, and Uterine Transplants
417
History
418(3)
Ethical Issues
421(9)
An Update on UNOS Policy and Procedures Regarding VCAs
430(1)
Conclusion
431(1)
Notes
431(4)
Index
435
Robert M. Veatch is Professor of Medical Ethics at the Kennedy Institute of Ethics, Georgetown University. He is a member of the Board of Directors of the Washington Regional Transplant Community as well as the Ethics Committee and the Vascular Composite Allografts Committee of the United Network for Organ Sharing. He has received the Lifetime Achievement Award from the American Society of Bioethics and Humanities, the Henry Knowles Beecher Award from the Hastings Center, and gave the Gifford Lectures at the University of Edinburgh. He is the author of fifty books including The Basics of Bioethics and Case Studies in Biomedical Ethics. Lainie F. Ross is the Carolyn & Matthew Bucksbaum Professor of Clinical Medical Ethics at the University of Chicago; professor in the departments of Pediatrics, Medicine, Surgery and the College; associate director of the MacLean Center for Clinical Medical Ethics; and codirector of the Institute for Translational Medicine. She is a recipient of the Patricia Price Brown Prize in Biomedical Ethics from the Oklahoma Health Sciences University and a John Simon Guggenheim Memorial Foundation Fellowship. She is the author of two books, Children, Families and Health Care Decision-Making and Children in Medical Research: Access versus Protection.