Jürgen Boomgaarden

Pekka Louhiala

Urban Wiesing

With the advances of medicine, questions of medical ethics have become more urgent and are now considered of great social and political significance. An innovatively designed, activity-based workbook, this text was prepared using papers and case studies collected from several countries in the European Union. It reflects the issues and concerns that confront clinical practitioners throughout Europe and elsewhere today and presents varying national responses in law and policy to these concerns, as identified by ethicists, lawyers, theologians and practitioners. The problems they examine include the relationship between medical research and medical practice, elementary regulations of medical research, the complexity of informed consent, and the role of the sponsor or scientific community.

Issues in Medical Research Ethics

This is the first book that covers comprehensively the difficult ethical issues involved in prevention of intellectual disability (learning disability, mental retardation). These issues are discussed both practically and theoretically in the light of four case examples drawn from real life. The cases demonstrate various issues raised by the concept of preventing intellectual disability, including definition, epidemiology, screening, and genetic counselling. Two major approach models (reproductive autonomy and public health) are scrutinised, and the practical issues of prevention are examined closely with respect to three syndromes (Down, Fragile X, and Aspartylugosaminuria). The question 'Why should intellectual disability be prevented?' is examined thoroughly at each stage. As a paediatrician and a philosopher, Dr Louhiala presents the issues in a way that is both user-friendly and philosophically sound.

Ethical and Clinical Issues

Preventing Intellectual Disability

This book provides a perspective on the concepts placebo and placebo effects, which has been missing so far: a detailed analysis of the history of the terms, their current use, suggested alternatives and the implications of the conceptual confusion. Everybody knows something about placebos and placebo effects. If, however, people are asked to define the concepts, the spectrum becomes wide. Does 'placebo' refer to an inert treatment or does it cover all elements of the patient-physician-interaction except for pharmacological or other physiological mechanisms? Furthermore, if, by definition, a placebo has no effect, what sense does it make to talk about a 'placebo effect'? Even in scientific literature the concepts ‘placebo’ and ‘placebo effect’ are used in many senses and often in a confusing way. While this book discusses many issues which keep puzzling physicians, it also covers the historical developments of the concepts of placebo and placebo effect as well as the conceptual confusion in the definitions. This book is intended for physicians, philosophers, psychologists and any other people interested in placebos, placebo effects and the physician-patient relationship.

Pekka Louhiala

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