Qualified, specialist

Psychiatry and religious/spiritual share an interest in human flourishing, a concern with beliefs and values, and an appreciation for community. Yet historical tensions between science and religion have often reinforced disciplinary boundaries and obstructed dialogue, leaving clinicians uncertain about how to approach ethical dilemmas arising between them. Common questions concern conflicting values, the ways that religion/spirituality informs the value commitments of patients and their clinicians, and what principles should guide the interaction between clinicians’ own professional and personal commitments.This volume aims to help readers think more clearly about these issues as they present to psychiatrists and other mental health professionals, religious professionals working in mental health settings, bioethicists and trainees in these disciplines. Rather than philosophical arguments or practice guidelines, chapter authors offer a conceptual framework for understanding the role of religion/spirituality in ethical decision-making, as well as pragmatic guidance for approaching challenging cases. Authors in Part One explore several dimensions of the ethical challenges presented by religious/spiritual related to diagnosis, integrated treatment, harmful religion, and the work of ethics committees and religious professionals. Those in Part Two consider ways of approaching these issues as they arise in different clinical contexts, such as forensic, consultation-liaison, geriatric, child, international and community psychiatry, as well as in psychiatric research and teaching.Less

No specialty faces more diverse and challenging ethical dilemmas than palliative medicine. What is the best way to plan ahead for the end of life? How should physicians respond when patients refuse treatments likely to be beneficial or demand treatments not likely to be? Who makes medical decisions for patients who are too ill to decide for themselves? Do patients have the “right to die” (and, if so, what exactly does that mean)? Other ethics texts have explored these issues but often from an academic perspective that overlooks the practical realities of clinical medicine. Conversely, medical textbooks frequently lack sufficient philosophical depth to fully explore the complexities of these issues. This complete guide to the ethics of palliative care combines clinical experience with philosophical rigor to provide a comprehensive analysis of this fascinating field. Using relevant case studies, core subjects such as intensive symptom management at the end of life, physician-assisted dying, and palliative sedation are examined from historical, legal, clinical, and ethical perspectives. Whereas pediatric issues are often an afterthought in palliative care textbooks, this guide explores the unique nature of ethical dilemmas in the prenatal, neonatal, and adolescent age groups. Other important topics such as neuro-palliative care, organ donation, research, and moral distress are also covered in detail. Written with clinical nuance for medical professionals—and clear language as well as a glossary for lay readers—this guide offers all readers an opportunity to explore and understand the fascinating ethical issues facing patients suffering from life-threatening illness.Less

Raising a child with multiple special needs or disabilities is a time-consuming and difficult task that exceeds the usual parameters of parenting. This book examines all the facets of that task, from the better-known physical, financial, and emotional burdens to the previously invisible moral work involved. Drawing from narratives written by parents of children with a variety of special needs, academic research in ethics and disability, and personal experience in pediatrics, this book begins to recognize the moral consequences of providing long-term care for a child with complex needs. Using a virtue ethic framework based on Joan Tronto’s phases of care, it isolates the various tasks involved and evaluates the moral demands placed on the parent performing them. Raising a child with special needs requires an excess of attentiveness, responsibility, competence, and responsiveness, and demands from the parent a reassessment of their personal and social lives. In each phase, moral work must be done to become the sort of person who can perform the necessary caregiving. Some of the consequences are predictable, such as the emotional and physical burden of constant attentiveness and numerous unexpected responsibilities. But the need for competence, which drives an acquisition of medical knowledge, has not previously been analyzed. Nor has there been recognition of the enormous moral task of encouraging identity formation in a child with intellectual delays or autism. For a child who cannot attain independence, parents must continue to provide care and support into an uncertain future.Less

Spiritual sickness troubles American medicine. Through a death-denying culture, medicine has gained enormous power—an influence it maintains by distancing itself from religion and spirituality, which too often remind us of our mortality. As a result of this separation of medicine from spiritual traditions, patients facing serious illness infrequently receive adequate spiritual care despite the large body of empirical data demonstrating its import to patient meaning-making, quality of life, and medical utilization. This secular–sacred divide also unleashes depersonalizing social forces through the market, technology, and legal-bureaucratic powers that reduce clinicians to tiny cogs in an unstoppable machine. Hostility to Hospitality is one of the first books of its kind to explore these hostilities threatening medicine and offer a path forward for the partnership of modern medicine and spirituality. Drawing from interdisciplinary scholarship including empirical studies, interviews, history and sociology, theology, and public policy, the authors argue for structural pluralism as the missing piece to changing hostility to hospitality.Less

Rated as one of the top 15 breakthroughs in medicine over the last 150 years, evidence-based medicine (EBM) has become highly influential in medicine, and promotes the seemingly irrefutable principle that decision-making in medical practice should be based, as much as possible, on the most up-to-date research findings. EBM has been particularly popular within psychiatry, a field that is haunted by a legacy of controversial interventions. For advocates, anchoring psychiatric practice in research data makes psychiatry more scientific valid and ethically legitimate. Few, however, have questioned whether EBM, a concept pioneered by those working in other areas of medicine, can be applied to psychiatric disorders. This resource analyzes the basic assumptions of EBM, and critically examines their applicability to psychiatry. By highlighting the basic ethical tensions between psychiatry and EBM, the author addresses the fundamental and controversial question of whether psychiatrists should practice evidence-based medicine at all.Less

Patient expectations for immediate, risk-free healthcare have never been greater; the scrutiny that the medical profession face to deliver this perfect care has also never been greater; the complexity of the law under which we work and practise is ever-increasing, yet clinicians are meant to have an up-to-date understanding of all these matters. Many legal texts are written in ‘legalese’ language, which may be off-putting or confusing to the medical professional, especially in times of urgency and stress. This book has been written in an attempt to overcome these concerns while specifically aimed at the non-legally trained healthcare practitioner. It offers pragmatic easy-to-access information and guidance for the busy clinician needing to check the legal landscape before, during, or after treatments and consultations. This book is designed to be your number one reference for all medicolegal matters that demand an immediate answer. Each chapter details pertinent case law, statutes and legislation, and professional guidance, before considering specific aspects of medicolegal importance. Sections of text are complimented with a ‘key points’ summary box to act as a reminder or revision aid. Further reading is suggested at the end of each chapter, including links to websites that can provide up-to-date advice as the law changes and evolves. An alphabetical glossary of legal terms at the end of the book offers a rapid and easy reference that supports every chapter.Less

Written by international experts, this resource lays out the moral, legal and ethical restraints to using donors after cardiac death for organ transplant, together with the techniques that have been adopted to improve their outcome. The different approaches and results of renal transplant according to country are covered along with the procedures and outcomes adopted to use other organs, notably the liver and lungs.Less