Thesis (Ph.D.)--Bowling Green State University, 2007. / Document formatted into pages; contains xiv, 166 p. Includes bibliographical references.

Genetic medicine is an emerging area of healthcare which constantly raises novel ethical challenges in the clinical realm due to its capacity to reveal information that has deeply personal meaning. Genetic tests can reveal more than is strictly essential for immediate medical care because they can diagnose conditions that cannot be cured, treated or effectively managed. The diagnosis of a genetic condition in one individual can have repercussions throughout an extended family, and genetic knowledge has created innovative, technologically driven, reproductive options. For clients of genetic counselling, moral choice does not readily result from uncluttered logic or easy personal preference, nor does it involve the application of sterile principles and laws, but is a much richer process involving personal history and culture, as well as reflection upon personal values, current resources and projected life goals. For these reasons, I question the validity of the exclusive use of a narrow version of Principlism, as it is commonly operationalised, for the medical sub-specialty of clinical genetics. Its heavy emphasis on individual autonomy, which has become synonymous with clinical medicine, does not take into account the fact that most genetic tests have little or no immediate clinical utility, or that genetic medicine is primarily about the way in which genetic conditions pass through families, and management of recurrence risks by choice of reproductive options. Therefore, the aim of this dissertation is to develop and explore a broader contextual moral framework, which is better suited to deliberation about complex ethical dilemmas in clinical genetics, than the current dominant approach which tends to follow a restrictive and non-inclusive application of Principlism. To achieve this aim, I have started with a review of relevant history and socio-political forces that have shaped the current status of the genetic medicine, and examined the evolution of current attitudes that underpin recognition, analysis and management of the ethical challenges in genetic medicine. I have analysed the manner in which Principlism and other normative theories are employed by bioethicists and clinicians in response to ethical dilemmas, and presented an alternative approach which employs a broader contextual ethical framework. I have devised an approach which attends to the importance of both current social opinion, and the tradition of evidence-based medicine, with reference to selected traditions in philosophical analysis. vi In conclusion, I advocate attention to concrete circumstances, which includes recognition of historical development, which has shaped current medical and wider social values, beliefs, norms and attitudes political context, including critical analysis of relevant political motivations social context, particularly situational power structures, trust relationships and relational obligations personal values, resources and experiences of the stakeholder(s) the range of realistically available options for the stakeholder(s) the impact of economic limits, which might be institutional and / or personal And, to achieve this objective of building a ‘thick’ ethical discourse, I propose a series of questions, which can be readily utilised by genetic and non-genetic health professionals as well as other members of society to work towards resolutions that represent a balance of fairness, economic responsibility with scarce resources, and socially acceptability. This approach appropriately attends to the relational and communicative aspects of moral dilemmas in clinical genetics, and is likely to yield more meaningful (and less likely paternalistic) conclusions, which would be of greater value to our morally pluralist society.

<p>It is self evident that our society is an information one. This is true from the things we see around us.The world is now a global village.It just take seconds for communication to be established from one part of the globe to another.What a tremendous achievement for information technology.Among the recent developments of information technology is the scientific wizardary of cyber medicine.The internet has definitely revolutionalised the healthcare industry. Many people in developed countries of the world seek medical information, advice or even buy drugs via the internet.So many websites rise every now and then claiming to provide various medical assistance to patients. But the application of information technology to medicine poses some ethical problems today. It is because of this that cyber medicine attracts my attention in this research.With this research, I hope to offer some recommendations for a morally acceptable cyber medicine .This will help to some extent in solving this all important problem ofcyber medicine for the good of the health care industry and the society at large.</p>

Thesis (M.A.)--York University, 2004. Graduate Programme in Interdisciplinary Studies. / Typescript. Includes bibliographical references (leaves 87-95). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99380

Thesis (M.A.)--York University, 2004. Graduate Programme in Interdisciplinary Studies. / Includes bibliographical references (p. 87-95). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99380

This dissertation will support full ethical endorsement of terminal sedation for those most urgently in crisis and need of beneficence, those who are dying and in the final hours or days and suffering. To clarify the practice I first detail ethical differences between euthanasia, physician assisted suicide and terminal sedation. Moreover, I identify new areas where harms and benefits need to be evaluated as affecting not only patients, but also families and caregivers. I evaluate the current practice to allow the development of ethical guidelines and greater consensus on deciding the hard cases. This work may also serve to assist those looking to enlarge the practice in the future with ETS for those with debilitating diseases or disability, but they are not my primary goal. Below is the standard I propose for moral allowability for the use of terminal sedation. I will refer to it often in the pages that follow simply as my standard . Terminal sedation is the appropriate and intentional use of medications (benzodiazepines and/or narcotics) to produce ongoing, deep unconsciousness upon 1) a terminal patient’s (or surrogates) request due to 2) suffering intractable pain or other distressing clinical symptoms intolerable to the patient when 3) death is expected within hours or days (less than two weeks) due to the terminal illness, injury, or disease. I offer two versions of initial guidelines for development of hospital policy. The first version outlines minimal guidelines that ought to be utilized to allow TS for patients who fit my standard. The minimal guideline is based upon the recommendations of the American Medical Association with some modifications. The guideline is admittedly restrictive in hopes of gaining wider societal support for a currently controversial practice. Secondly, I offer more moderate guidelines for policy that could become a standard in the future. It maintains the restrictive focus of the minimal guidelines and offers additional education and support to others which has yet to be broadly provided. The moderate guidelines would mark an important step forward for allowing more choices in dying and offering additional supports to those involved with dying patients.

It is self evident that our society is an information one. This is true from the things we see around us.The world is now a global village.It just take seconds for communication to be established from one part of the globe to another.What a tremendous achievement for information technology.Among the recent developments of information technology is the scientific wizardary of cyber medicine.The internet has definitely revolutionalised the healthcare industry. Many people in developed countries of the world seek medical information, advice or even buy drugs via the internet.So many websites rise every now and then claiming to provide various medical assistance to patients. But the application of information technology to medicine poses some ethical problems today. It is because of this that cyber medicine attracts my attention in this research.With this research, I hope to offer some recommendations for a morally acceptable cyber medicine .This will help to some extent in solving this all important problem ofcyber medicine for the good of the health care industry and the society at large.

Background: 1985 saw the beginnings of a population-based biobank in Västerbotten County, Sweden. In 1999, a start-up genomics company, UmanGenomics, obtained ‘all commercial rights’ to the biobank. The company introduced an ethics policy, which was well received in prestigious journals, focusing on public oversight and informed consent. Aims: To explore how social anthropology can aid understanding of the challenges posed by the new role of the biobank in Västerbotten, and thus complement more established traditions in the field of medical ethics. An anthropological study of the ethics policy was executed. Theoretical perspective: Inspired by the anthropology of policy and social science perspectives on ethics and morality, the policy was studied at three analytical levels: policymakers (who formulate the policy), policy workers (who implement the policy, primarily nurses who obtain informed consent) and target group (for whom and on whom the policy is supposed to work: the potential donors to the biobank). Methods: Policymakers, nurses, and potential donors were interviewed, donations observed, and official documents analysed to mirror the moral problematizations made at the three levels in each other and to study the practical implications of the policy. To extend the reliability of the findings two surveys were executed: one among the general population, one among donors. Results: The qualitative studies show that policymakers distinguish between blood and data differently to potential donors. Informed consent seems more important to policymakers than potential donors, who are more concerned about political implications at a societal level. Among the respondents from the survey in the general public, a majority (66.8%) accepted surrogate decisions by Research Ethics Committees; a minority (4 %) stated informed consent as a principal concern; and genetic research based on biobank material was generally accepted (71%). Among the respondents to the survey in donors, 65% knew they had consented to donate a blood sample, and 32% knew they could withdraw their consent; 6% were dissatisfied with the information they had received; and 85% accepted surrogate decisions by Research Ethics Committees. Discussion: The ethics policy constitutes a particular naming and framing of moral problems in biobank-based research which overemphasises the need for informed consent, and underemphasises other concerns of potential donors. This embodies a political transformation where access to stored blood and medical information is negotiated in ethical terms, while it also has unacknowledged political implications. In particular, the relations between authorities and citizens in the Swedish welfare state are apparently transforming: from mutual obligation to individual contracts. Conclusion: Anthropology contributes to medical ethics with increased awareness of the practical implications of particular research ethical initiatives. This awareness promotes appreciation of the political implications of ethics policies and raises new issues for further consideration.

Thesis (doctoral)--Universität, Münster (Westfalen), 2000. / Includes bibliographical references (p. 286-320).

Thesis (M.A.)--Denver Seminary, 1997. / Includes bibliographical references (leaves [115]-122).