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Ethics and Law for the Health Professions


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Table of Contents

Introduction What is Ethics Ethical Theories and Concepts Relativism and Pluralism Introduction to Principle-Based Ethics Introduction to Law Clinical Ethics and Ethical Decision-Making The Student in the Health-Care Environment Professionalism and Standards of Care Professional Competence and the Issues of Negligence Veracity Assessing Competence Decision-Making for Non-Competent Adults and Children Consent Confidentiality and Record-Keeping Treatment and Non-Treatment Issues: The Limits of Medical Care CPR and No-CPR orders Nursing The Elderly The Aboriginal and Torres Strait Islander Health People with Mental Illness Euthanasia Post-Coma Unresponsiveness (Vegetative State) and Brainstem Death Organ Donation and Transplantation Genetics Abortion Assisted Reproductive Technology Complementary and Alternative Medicine (CAM) Biomedical Research Resource Allocation and Health Policy Public Health, HIV/AIDS and Infectious Diseases The Pharmaceutical Industry


In 1979, the American authors Tom L Beauchamp and James F Childress published the first edition of Principles of Biomedical Ethics. They espoused the theory of what has come to be known as "principlism" as a bridge between the deontological and utilitarian approaches to bioethics. They identified four central values - autonomy, beneficence, non-maleficence and justice - as the fundamental moral principles in terms of which to address ethical dilemmas in biomedical theory and practice. Since 1979, Principles of Biomedical Ethics has gone through five editions, and has become a virtually magisterial text, at least in the English speaking world. Ethics and Law for the Health Professions bids fair to become equally magisterial in the Australian context. Now in its second edition, it too espoused the principlist approach to bioethical issues, but, like its American counterpart, it acknowledges also the significance of other subsidiary values - professional integrity, veracity, confidentiality, privacy and fiduciary responsibility - to mention but a few. Ethics and Law for the Health Professions professes to be an introductory text in bioethics and law. It can be used as a teaching resource or as a handbook. It is both comprehensive and detailed, and although the average length of each of its thirty-one chapters is only twenty pages, there is sufficient substance in each chapter both to outline the issues involved and to point towards a resolution. Not everyone - including this reviewer - will agree with all the resolutions. A liberal individualist view of autonomy and a utilitarian assessment of beneficence tend to hold sway, but other perspectives are carefully examined, and a fair and very up-to- date selection of references is appended to the end of each chapter. What is particularly to be commended is the structure of the text. The separation of ethics and law in each chapter underlines a very important distinction when addressing these issues. Otherwise the legal decisions can be accepted as putting an end to ethical debate. Further, the "hot" topics of euthanasia, abortion, IVF, stem cell research, etc., are addressed in the latter third of the book, and to this degree need to be seen against the general ethical and legal theories which are discussed in the first third, and the "procedural" values - veracity, confidentiality, professionalism, etc. - which occupy the middle chapters. There are special chapters on various classes of patients: the elderly; Aboriginal and Torres Strait Islanders; and those suffering from mental illness and post-coma unresponsiveness and the authors do not resile from presenting strong challenges to contemporary ethical practice, especially in the chapters on organ donation and brain death, experimentation in animals, resource allocation, complementary and alternative medicine and the pharmaceutical industry. In all, this is an excellent text, and I am sure, like its American counterpart, it will go through many editions. - William J Uren SJ, Australian Health Review, Vol 29 No 3, August 2005

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