Medicine, ethics, and theology embrace various ideas and concepts regarding human suffering - ranging from pain, suffering from loneliness, a lack of meaning or finitude, to a religious understanding of suffering, grounded in a suffering and compassionate God. In the practices of clinical medical ethics and health care chaplaincy, these diverse concepts overlap. What kind of conflicts arise from different concepts in patient care and counseling, and how should they be dealt with in a reflective way? Fostering international interdisciplinary scientific conversations, the book aims to deepen the discussion in medical ethics concerning the understanding of suffering, and the caring and counseling of patients.
Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, in part a reflection of the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish that occurs when the burdens of treatment appear to outweigh the benefits; scarce human and material resources must be allocated; informed consent is incomplete or inadequate; or there are disagreements about goals of treatment among patients, families or clinicians. Each is a source of moral adversity that challenges clinicians' integrity: the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. If moral suffering is unrelieved it can lead to disengagement, burnout, and undermine the quality of clinical care. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. It is vital to shift the focus to solutions and to expanded individual and system strategies that mitigate the detrimental effects of moral suffering. Moral resilience, the capacity of an individual to restore or sustain integrity in response to moral adversity, offers a path forward. It encompasses capacities aimed at developing self-regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum approach, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all.
In this profoundly theological reflection on illness, healing, and the doctor-patient relationship, pediatrician Margaret Mohrmann bridges the sometimes disparate worlds of medicine and faith, of high technology and ultimate concern. Drawing on her two decades of experience treating children who suffer from disease and dysfunction, Mohrmann movingly reveals the temptations of idolatry that beset our understanding of health and life, the intrinsic connectedness underlying all medical encounters, and the difficulties and riches of using scripture as a moral resource. In clear, accessible language Mohrmann emphasizes the importance of interpreting the lives of the suffering as meaningful and ongoing stories - stories that require all of us to respond in healing ways. Uncovering insights from such diverse sources as the apostle Paul, Alasdair MacIntyre and Flannery O'Connor, she suggests that what is required for a truly human life is not the absence of pain, but the presence of others. Both pastoral and prophetic, Medicine as Ministry is a challenge to rethink the purposes of health care - and to better discern the human condition.
Contemporary discourse in biomedical ethics has been greatly shaped, sustained and enriched through the insights and perspectives offered by its theologian-contributors. This volume examines the work of four Christian theologians who have significantly influenced the field of bioethics in the U.S.: Richard McCormick, SJ; Paul Ramsey; Stanley Hauerwas; and James M. Gustafson. Each theorist's writings are explored in turn, in order to elucidate, compare and contrast their foundational theological premises, their particular approaches to moral reasoning, and their considered responses to selected medico-moral issues. The final chapter reflects some of the author's own critical responses in dialogue with the study's four subjects, and offers general suggestions about the moral perspective afforded by Christian theology. This volume should be of interest both to those seeking a fuller understanding of contemporary discussions in bioethics and to those studying Christian ethics in the modern era.
This book offers an interdisciplinary effort to address global health issues grounded on a human rights framework seen from the perspective of those who are more vulnerable to be sick and die prematurely: the poor. Combining his scholarship and service in impoverished communities, the author examines the connection between poverty and health inequalities from an ethical perspective that considers contributions from different disciplines and the voices of the poor.
Collecting a wide range of contemporary and classical essays dealing with medical ethics, this huge volu me is the finest resource available for engaging the pressin g problems posed by medical advances. '
Long before it cured disease, medicine aimed to relieve suffering-but despite that precedence, the relief of suffering often takes a back seat in today's biomedical research and treatment. Modern bioethics, too, has been slow to come to terms with suffering. Attention to ethical quandaries has sometimes displaced attention to the experience of patients. This book seeks to place suffering at the center of bioethical thinking once again. Among the questions its contributors explore are: What is the meaning of suffering? How does it relate to pain? If there can be pain without suffering, can there be suffering without pain? Does suffering require advanced cognitive abilities? Can animals suffer? Many believe that we have strong obligations to relieve or minimize suffering; what are the limits of these obligations? Does the relief of suffering justify the termination of a patient's life, as proponents of euthanasia maintain? What is the bearing of suffering on the cherished bioethical principle of autonomy? Can suffering impair a patient's ability to make reasoned choices? To what extent must the encounter with suffering be an important component of medical education? Do religious traditions ever move from efforts to explain and relieve suffering to positions that justify and promote it? The aim of this book is to undertake a new foray into this "foreign territory" of suffering. With a foreword by the distinguished bioethicist Daniel Callahan, its twenty-two chapters, authored by leading scholars in science and bioethics, are organized so as to examine suffering in its biological, psychological, clinical, religious, and ethical dimensions.
How does the market affect and redefine healthcare? The marketisation of Western healthcare systems has now proceeded well into its fourth decade. But the nature and meaning of the phenomenon has become increasingly opaque amidst changing discourses, policies and institutional structures. Moreover, ethics has become focussed on dealing with individual, clinical decisions and neglectful of the political economy which shapes healthcare. This interdisciplinary volume approaches marketisation by exploring the debates underlying the contemporary situation and by introducing reconstructive and reparative discourses. The first part explores contrary interpretations of ‘marketisation’ on a systemic level, with a view to organisational-ethical formation and the role of healthcare ethics. The second part presents the marketisation of healthcare at the level of policy-making, discusses the ethical ramifications of specific marketisation measures and considers the possibility of reconciling market forces with a covenantal understanding of healthcare. The final part examines healthcare workers’ and ethicists’ personal moral standing in a marketised healthcare system, with a view to preserving and enriching virtue, empathy and compassion. Chapters 4 and 7 of this book are freely available as downloadable Open Access PDFs at http://www.taylorfrancis.com under a Creative Commons Attribution-Non Commercial-No Derivatives (CC-BY-NC-ND) 4.0 license.
