Stuart J. Youngner – författare

The use of human tissue for transplantation is becoming a billion-dollar business. This book is the first comprehensive exploration of the American tissue transplantation industry. It traces the chain of distribution of musculoskeletal tissue (e.g. bones and ligaments) and skin from the generous donation of grieving families to its transplantation into hundreds of thousands of persons each year. Commodification, commercialization, and the occasional use of tissue for "cosmetic" surgery have raised ethical questions about the acceptability of "markets" in human body parts that have been altruistically donated by families. Inevitably, questions about the informed consent and the need for responsible stewardship by the industry have been raised, often in the Press.The book provides a comprehensive background to these ethical problems by explaining the historical development, breadth, and organization of the tissue industry, including the technical developments that have made it simultaneously clinically relevant and an attractive market for investment capital. It explores the similarities and differences in how government regulates other tissues and solid organs (such as hearts and kidneys). Contributions to the book come from an interdisciplinary group of scholars, industry representatives, government regulators, and, not least, families who have donated tissue from their dead loved ones.

This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients' values has been recognized as the essential moral component of clinical decision-making. Technology's promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns-whether ethics consultation is best done by individuals, teams, or committees; how an ethics consult service should be structured; the need for institutional support; and techniques and programs for educating and training staff-without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics.

The Definition of Death: Contemporary Controversies is the first comprehensive review of the clinical, philosophical, and public policy implications of our effort to redefine the change in status from living person to corpse. It is the result of a collaboration among internationally recognized scholars from the fields of medicine, philosophy, social science, law, and religious studies. Throughout, the contributors struggle to reconcile inconsistencies and gaps in our traditional understanding of death and to respond to the public's concern that, in the determination of death under current policies, patients' interests may be compromised by the demand for organ retrieval.