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Sample records for medical ethics principles

  1. Ancient Chinese medical ethics and the four principles of biomedical ethics.

    PubMed Central

    Tsai, D F

    1999-01-01

    The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs". PMID:10461594

  2. Principles of Biomedical Ethics

    PubMed Central

    Athar, Shahid

    2012-01-01

    In this presentation, I will discuss the principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues. I will also discuss three cases to exemplify some of the conflicts in ethical decision-making. PMID:23610498

  3. Application of legal principles and medical ethics: multifetal pregnancy and fetal reduction

    PubMed Central

    Cheong, May Anne; Tay, Catherine Swee Kian

    2014-01-01

    In the management of complex medical cases such as a multifetal pregnancy, knowledge of the ethical and legal implications is important, alongside having competent medical skills. This article reviews these principles and applies them to scenarios of multifetal pregnancy and fetal reduction. Such a discussion is not solely theoretical, but is also relevant to clinical practice. The importance of topics such as bioethical principles and informed consent are also herein addressed. PMID:25017403

  4. Ethics in medical research: General principles with special reference to psychiatry research

    PubMed Central

    Avasthi, Ajit; Ghosh, Abhishek; Sarkar, Sidharth; Grover, Sandeep

    2013-01-01

    Ethics is an understanding of the nature of conflicts arising from moral imperatives and how best we may deal with them. Ethics in medical research deals with the conflicts of interest across various levels. Guidelines have been proposed for standardized ethical practice throughout the globe. The four fundamental principles of ethics which are being underscored are autonomy, non-maleficence, beneficence, and justice. Some special ethical issues have particular relevance to psychiatric research arising primarily from the specific vulnerabilities of those with mental illness and the risks posed by some research methodologies. Accordingly, sensitivity is required in the design of psychiatric research. It is suggested that though the value of published guidelines and the help that may be available from research ethics committees is quite great, the primary responsibility for maintaining high standards of practice in research rests with research workers themselves. PMID:23440168

  5. Is Rorty’s Neopragmatism the “Real” Foundation of Medical Ethics: a Search for Foundational Principles

    PubMed Central

    Branch, William T

    2006-01-01

    Principlism, the predominate approach to bioethics, has no foundational principles. This absence of foundations reflects the general intellectual climate of postmodern relativism. Even America’s foremost public philosopher, Richard Rorty, whose pragmatism might suggest a philosophy of commonsense, seems to be swimming in the postmodern swamp. Alternatively, principlism’s architects, Beauchamp and Childress, suggest a constantly evolving reflective equilibrium with some basis in common morality as a workable framework for twenty-first century bioethics. The flaw in their approach is failure to conform to real doctors’ and patients’ experiences. Real doctors adopt a scientific paradigm that assumes an objective reality. Patients experience real suffering and seek effective cures, treatments, palliation and solace. The foundation of medical ethics should be that doctors altruistically respond to their patients’ suffering using scientifically acceptable modalities. Compassion, caring, and respect for human dignity are needed as guides in addition to justice, beneficence, nonmaleficence and respect for autonomy. PMID:18528478

  6. The Secret Kappa Lambda Society of Hippocrates (and the Origin of the American Medical Association's Principles of Medical Ethics).

    PubMed

    Ambrose, Charles T

    2005-01-01

    This paper relates the neglected history of an idealistic, secret medical fraternity which existed briefly in Lexington, Kentucky, during the first half of the 19th century. It was created for students in the Medical Department at Transylvania University, the fifth US medical school, founded in 1799. One goal of the fraternity was to counter the widespread dissension and often violent quarrels among doctors that characterized American medicine of that period. And to that end, it was among the first to promote Thomas Percival's code of medical ethics in this country. Branches of the fraternity were established in Philadelphia and New York City, where members became influential in local medical politics but in time encountered hostility from rival physicians. The secret character of the fraternity branches was publicized and maligned during an anti-Masonic movement in this country in the 1830s, which soon led to the demise of the Philadelphia group. The New York branch remained active through the 1860s. Members of both branches were among those who in 1847 established the American Medical Association and devised its Principles of Medical Ethics. PMID:16197729

  7. Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics.

    PubMed

    Gillon, Raanan

    2015-01-01

    This paper argues that the four prima facie principles-beneficence, non-maleficence, respect for autonomy and justice-afford a good and widely acceptable basis for 'doing good medical ethics'. It confronts objections that the approach is simplistic, incompatible with a virtue-based approach to medicine, that it requires respect for autonomy always to have priority when the principles clash at the expense of clinical obligations to benefit patients and global justice. It agrees that the approach does not provide universalisable methods either for resolving such moral dilemmas arising from conflict between the principles or their derivatives, or universalisable methods for resolving disagreements about the scope of these principles-long acknowledged lacunae but arguably to be found, in practice, with all other approaches to medical ethics. The value of the approach, when properly understood, is to provide a universalisable though prima facie set of moral commitments which all doctors can accept, a basic moral language and a basic moral analytic framework. These can underpin an intercultural 'moral mission statement' for the goals and practice of medicine. PMID:25516950

  8. Ethical principles and concepts in medicine.

    PubMed

    Taylor, Robert M

    2013-01-01

    Clinical ethics is the application of ethical theories, principles, rules, and guidelines to clinical situations in medicine. Therefore, clinical ethics is analogous to clinical medicine in that general principles and concepts must be applied intelligently and thoughtfully to unique clinical circumstances. The three major ethical theories are consequentialism, whereby the consequences of an action determine whether it is ethical; deontology, whereby to be ethical is to do one's duty, and virtue ethics, whereby ethics is a matter of cultivating appropriate virtues. In the real world of medicine, most people find that all three perspectives offer useful insights and are complementary rather than contradictory. The most common approach to clinical ethical analysis is principlism. According to principlism, the medical practitioner must attempt to uphold four important principles: respect for patient autonomy, beneficence, nonmaleficence, and justice. When these principles conflict, resolving them depends on the details of the case. Alternative approaches to medical ethics, including the primacy of beneficence, care-based ethics, feminist ethics, and narrative ethics, help to define the limitations of principlism and provide a broader perspective on medical ethics. PMID:24182363

  9. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

    PubMed

    2014-01-01

    Published research in English-language journals are increasingly required to carry a statement that the study has been approved and monitored by an Institutional Review Board in conformance with 45 CFR 46 standards if the study was conducted in the United States. Alternative language attesting conformity with the Helsinki Declaration is often included when the research was conducted in Europe or elsewhere. The Helsinki Declaration was created by the World Medical Association in 1964 (ten years before the Belmont Report) and has been amended several times. The Helsinki Declaration differs from its American version in several respects, the most significant of which is that it was developed by and for physicians. The term "patient" appears in many places where we would expect to see "subject." It is stated in several places that physicians must either conduct or have supervisory control of the research. The dual role of the physician-researcher is acknowledged, but it is made clear that the role of healer takes precedence over that of scientist. In the United States, the federal government developed and enforces regulations on researcher; in the rest of the world, the profession, or a significant part of it, took the initiative in defining and promoting good research practice, and governments in many countries have worked to harmonize their standards along these lines. The Helsinki Declaration is based less on key philosophical principles and more on prescriptive statements. Although there is significant overlap between the Belmont and the Helsinki guidelines, the latter extends much further into research design and publication. Elements in a research protocol, use of placebos, and obligation to enroll trials in public registries (to ensure that negative findings are not buried), and requirements to share findings with the research and professional communities are included in the Helsinki Declaration. As a practical matter, these are often part of the work of American IRBs, but not always as a formal requirement. Reflecting the socialist nature of many European counties, there is a requirement that provision be made for patients to be made whole regardless of the outcomes of the trial or if they happened to have been randomized to a control group that did not enjoy the benefits of a successful experimental intervention. PMID:25951678

  10. Medical Ethics

    MedlinePLUS

    ... personal health information: who has access to your records? Patient rights: Do you have the right to refuse treatment? When you talk with your doctor, is it ethical for her to withhold information from you or your family?

  11. Global ethics and principlism.

    PubMed

    Gordon, John-Stewart

    2011-09-01

    This article examines the special relation between common morality and particular moralities in the four-principles approach and its use for global ethics. It is argued that the special dialectical relation between common morality and particular moralities is the key to bridging the gap between ethical universalism and relativism. The four-principles approach is a good model for a global bioethics by virtue of its ability to mediate successfully between universal demands and cultural diversity. The principle of autonomy (i.e., the idea of individual informed consent), however, does need to be revised so as to make it compatible with alternatives such as family- or community-informed consent. The upshot is that the contribution of the four-principles approach to global ethics lies in the so-called dialectical process and its power to deal with cross-cultural issues against the background of universal demands by joining them together. PMID:22073817

  12. [Ethics in medical journals.

    PubMed

    Lifshitz, Alberto

    2013-01-01

    The title of this reflection evokes several contents that may encompass from ethics in research; fraud in science; ethics in medical advertising and relations between sponsors and science; and, finally, papers related to ethic content. This paper is limited to the ethic responsibilities of the medical writers or "scriptwriters." PMID:24290007

  13. Code of Ethics: Principles for Ethical Leadership

    PubMed Central

    Flite, Cathy A.; Harman, Laurinda B.

    2013-01-01

    The code of ethics for a professional association incorporates values, principles, and professional standards. A review and comparative analysis of a 1934 pledge and codes of ethics from 1957, 1977, 1988, 1998, 2004, and 2011 for a health information management association was conducted. Highlights of some changes in the healthcare delivery system are identified as a general context for the codes of ethics. The codes of ethics are examined in terms of professional values and changes in the language used to express the principles of the various codes. PMID:23346028

  14. Colonialism, Biko and AIDS: reflections on the principle of beneficence in South African medical ethics.

    PubMed

    Braude, Hillel David

    2009-06-01

    This paper examines the principle of beneficence in the light of moral and epistemological concerns that have crystallized in the South African context around clinical care. Three examples from the South African experience affecting the development of bioethics are examined: medical colonialism, the death in detention of Steve Biko, and the HIV/AIDS epidemic. Michael Gelfand's book [(1948). The sick African: a clinical study. Cape Town: Stewart Printing Company.] on African medical conditions captures the ambiguous nature of colonial medicine that linked genuine medical treatment with the civilizing mission. Biko's death was a key historical event that deeply implicated the medical profession under apartheid. The present HIV/AIDS epidemic presents the gravest social and political crisis for South African society. All three experiences influence the meaning and relevance of beneficence as a bioethics principle in the South African context. This paper argues for a South African bioethics informed by a critical humanism that takes account of the colonial past, and that does not model itself on an "original wound" or negation, but on positive care-giving practices. PMID:19361903

  15. An Ethical Issue in Medical Education of Obstetrics and Gynecology

    PubMed Central

    Choi, Seung Do; Woo, Su-Hyeon

    2015-01-01

    There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice. PMID:26793677

  16. An Ethical Issue in Medical Education of Obstetrics and Gynecology.

    PubMed

    Kim, Tae-Hee; Choi, Seung Do; Woo, Su-Hyeon

    2015-12-01

    There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice. PMID:26793677

  17. Ethical Principles: Guiding the Use of Animals in Research.

    ERIC Educational Resources Information Center

    Morrison, Adrian R.

    2003-01-01

    Presents arguments on the use of animals in biological and medical research. Discusses ethical considerations, principles, and animal rights in scientific research. (Contains 21 references.) (Author/YDS)

  18. Medical ethics in India.

    PubMed

    Desai, P N

    1988-08-01

    Medical ethics in the Indian context is closely related to indigenous classical and folk traditions. This article traces the history of Indian conceptions of ethics and medicine, with an emphasis on the Hindu tradition. Classical Ayurvedic texts including Carakasamhita and Susrutasamhita provide foundational assumptions about the body, the self, and gunas, which provide the underpinnings for the ethical system. Karma, the notion that every action has consequences, provides a foundation for medical morality. Conception, prolongation of one's blood-line is an important ethical aim of life. Thus a wide range of practices to further conception are acceptable. Abortion is a more complex matter ethically. At the end of life death is viewed in the context of passage to another life. Death is a relief from suffering to be coped with by the thought of an eternal atman or rebirth. PMID:3058850

  19. A comparative analysis of moral principles and behavioral norms in eight ethical codes relevant to health sciences librarianship, medical informatics, and the health professions

    PubMed Central

    Byrd, Gary D.; Winkelstein, Peter

    2014-01-01

    Objective: Based on the authors' shared interest in the interprofessional challenges surrounding health information management, this study explores the degree to which librarians, informatics professionals, and core health professionals in medicine, nursing, and public health share common ethical behavior norms grounded in moral principles. Methods: Using the “Principlism” framework from a widely cited textbook of biomedical ethics, the authors analyze the statements in the ethical codes for associations of librarians (Medical Library Association [MLA], American Library Association, and Special Libraries Association), informatics professionals (American Medical Informatics Association [AMIA] and American Health Information Management Association), and core health professionals (American Medical Association, American Nurses Association, and American Public Health Association). This analysis focuses on whether and how the statements in these eight codes specify core moral norms (Autonomy, Beneficence, Non-Maleficence, and Justice), core behavioral norms (Veracity, Privacy, Confidentiality, and Fidelity), and other norms that are empirically derived from the code statements. Results: These eight ethical codes share a large number of common behavioral norms based most frequently on the principle of Beneficence, then on Autonomy and Justice, but rarely on Non-Maleficence. The MLA and AMIA codes share the largest number of common behavioral norms, and these two associations also share many norms with the other six associations. Implications: The shared core of behavioral norms among these professions, all grounded in core moral principles, point to many opportunities for building effective interprofessional communication and collaboration regarding the development, management, and use of health information resources and technologies. PMID:25349543

  20. [Medical ethics and responsibility].

    PubMed

    Labram, Claude; Dusehu, Etienne

    2002-04-20

    In the matter of health, the care of a patient is not the same as that of a population. With regards to medical ethics, it is essential to differentiate that which is for the patient's well being, and that which relies on knowledge and responsibility, the principle of which is not to do harm. The health sector has become an important economic actor in our society. Any decision made must take into account the principle of well being and responsibility. The physicians' role, when making a decision, is to integrate not only the patient's quality of life but also the Public Health aspects, and to apply these notions to a well thought-out choice and shared with the patient. A triangle can be constructed with, at its base the percentage of the population concerned and at its peak the cost per beneficiary. This triangle can then be segmented at varying distance from its base, in current decisions applicable to the greatest number, and depending on the amount of resources available. PMID:12148129

  1. Introducing the Medical Ethics Bowl.

    PubMed

    Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah

    2016-01-01

    Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula. PMID:26788954

  2. Dharma and medical ethics.

    PubMed

    Seetharam, Sridevi

    2013-01-01

    Despite the numerous policies, regulations and laws aimed at promoting and ensuring ethical practice in healthcare, ethical misconduct remains rampant. Perhaps something more is needed to encourage a genuine and sustained moral attitude and behaviour. To a casual reader, the regulations on ethics read merely as a list of do's and don'ts and their philosophical foundation is not clear. In actuality, morality is often grounded in philosophy. Traditionally, religious and theistic philosophies drove moral behaviour. However, this is changing due to the current trend of secularism. Hindu philosophies are among the oldest philosophies that are still thriving, and this article explores these philosophies and compares and contrasts them with some of the contemporary ethical theories to assess if they can add value to the field of medical ethics. The main theme of the article is dharma or righteous conduct, the concepts related to it and how these can have a bearing on the development of an ethical attitude and the practice of medical ethics. PMID:24152344

  3. The Ethics of Medical Volunteerism.

    PubMed

    Stone, Geren S; Olson, Kristian R

    2016-03-01

    Responding to disparities in health, thousands of health care providers volunteer annually for short-term medical service trips (MSTs) to serve communities in need as a result of environmental, geographic, historical, or sociopolitical factors. Although well intentioned, short-term MSTs have the potential to benefit and harm those involved, including participants and communities being served. The contexts, resource and time limitations, and language and cultural barriers present ethical challenges. There have been increasing requests for standardized global guidelines, transparency, and open review of MSTs and their outcomes. Principles of mission, partnership, preparation, reflection, support, sustainability, and evaluation inform and equip those engaging in medical volunteerism. PMID:26900110

  4. [Crisis in medical ethics].

    PubMed

    Stellamor, K

    1996-01-01

    There is a disproportion between diagnostic and therapeutic medical achievements and the doctor/patient relationship. Are we allowed to do everything we are able to do in medicine? People are concerned and worried (genetic technology, invasive medicine, embryos in test tubes etc.). The crisis of ethics in medicine is evident. The analysis of the situation shows one of the causes in the shift of the paradigma-modern times to postmodern following scientific positivism-but also a loss of ethics in medicine due to an extreme secularism and to modern philosophical trends (Hans Jonas and the responsibility for the future and on the other hand modern utilitarism). PMID:9036685

  5. Ethics in Medical Research and Publication

    PubMed Central

    Masic, Izet; Hodzic, Ajla; Mulic, Smaila

    2014-01-01

    To present the basic principles and standards of Ethics in medical research and publishing, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the published literature. Investing in education of researches and potential researches, already in the level of medical schools. Educating them on research ethics, what constitutes research misconduct and the seriousness of it repercussion is essential for finding a solution to this problem and ensuring careers are constructed on honesty and integrity. PMID:25317288

  6. Islamic medical ethics: a primer.

    PubMed

    Padela, Aasim I

    2007-03-01

    Modern medical practice is becoming increasingly pluralistic and diverse. Hence, cultural competency and awareness are given more focus in physician training seminars and within medical school curricula. A renewed interest in describing the varied ethical constructs of specific populations has taken place within medical literature. This paper aims to provide an overview of Islamic Medical Ethics. Beginning with a definition of Islamic Medical Ethics, the reader will be introduced to the scope of Islamic Medical Ethics literature, from that aimed at developing moral character to writings grounded in Islamic law. In the latter form, there is an attempt to derive an Islamic perspective on bioethical issues such as abortion, gender relations within the patient-doctor relationship, end-of-life care and euthanasia. It is hoped that the insights gained will aid both clinicians and ethicists to better understand the Islamic paradigm of medical ethics and thereby positively affect patient care. PMID:17845488

  7. Teaching and Learning Medical Ethics

    PubMed Central

    Tiberius, Richard G.

    1981-01-01

    Three main questions are central to teaching and learning medical ethics. Can ethics be taught? If it can, what are some of its teachable components? And what teaching methods are appropriate? The author supports the concept of ethical competence as the basis of an ethical practice. Ethical competence is a set of insights, skills, understandings, ways of thinking which can be taught. The parallel is drawn between these kinds of competencies and the components of rigorous thinking characteristic of the training and experience of medical problem-solvers. Finally the author takes up four common criticisms of this approach. PMID:11650448

  8. Power and the teaching of medical ethics.

    PubMed Central

    Nicholas, B

    1999-01-01

    This paper argues that ethics education needs to become more reflective about its social and political ethic as it participates in the construction and transmission of medical ethics. It argues for a critical approach to medical ethics and explores the political context in medical schools and some of the peculiar problems in medical ethics education. PMID:10635507

  9. The implications of medical ethics.

    PubMed Central

    Thompson, I. E.

    1976-01-01

    In this paper, Mr Thompson, one of the research fellows appointed to the Edinburgh Medical Group research project, seeks to define medical ethics in relation to traditional ethics in the philosophical sense of enquiring into right and wrong modes of thought and conduct, and to carry that study further into the field of moral decisions made by doctors and other professional people who care for the sick. Until very recently the Victorian definition of medical ethics - medical etiquette - served the doctor well but the complexity of modern medicine and the involvement of other professional workers in medical care appears to have swept away the old framework and left a vacuum. A new medical ethic must be evolved to fill that vacuum, taking account not only of technological advances but also of relationships between doctors and other professionals associated with them and of the role in caring for the sick. PMID:781252

  10. Modeling Medical Ethics through Intelligent Agents

    NASA Astrophysics Data System (ADS)

    Machado, José; Miranda, Miguel; Abelha, António; Neves, José; Neves, João

    The amount of research using health information has increased dramatically over the last past years. Indeed, a significative number of healthcare institutions have extensive Electronic Health Records (EHR), collected over several years for clinical and teaching purposes, but are uncertain as to the proper circumstances in which to use them to improve the delivery of care to the ones in need. Research Ethics Boards in Portugal and elsewhere in the world are grappling with these issues, but lack clear guidance regarding their role in the creation of and access to EHRs. However, we feel we have an effective way to handle Medical Ethics if we look to the problem under a structured and more rational way. Indeed, we felt that physicians were not aware of the relevance of the subject in their pre-clinical years, but their interest increase when they were exposed to patients. On the other hand, once EHRs are stored in machines, we also felt that we had to find a way to ensure that the behavior of machines toward human users, and perhaps other machines as well, is ethically acceptable. Therefore, in this article we discuss the importance of machine ethics and the need for machines that represent ethical principles explicitly. It is also shown how a machine may abstract an ethical principle from a logical representation of ethical judgments and use that principle to guide its own behavior.

  11. Statement of Ethical Principles and Standards.

    ERIC Educational Resources Information Center

    Journal of College Student Development, 1990

    1990-01-01

    Presents "Statement of Ethical Principles and Standards" of American College Personnel Association (ACPA) to assist student affairs professionals in regulating behavior regarding ethical problems and daily practice standards. Suggests courses of action available to professionals observing unethical conduct by fellow professionals. Outlines ethical…

  12. How Many Principles for Public Health Ethics?

    PubMed Central

    Coughlin, Steven S.

    2009-01-01

    General moral (ethical) principles play a prominent role in certain methods of moral reasoning and ethical decision-making in bioethics and public health. Examples include the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Some accounts of ethics in public health have pointed to additional principles related to social and environmental concerns, such as the precautionary principle and principles of solidarity or social cohesion. This article provides an overview of principle-based methods of moral reasoning as they apply to public health ethics including a summary of advantages and disadvantages of methods of moral reasoning that rely upon general principles of moral reasoning. Drawing upon the literature on public health ethics, examples are provided of additional principles, obligations, and rules that may be useful for analyzing complex ethical issues in public health. A framework is outlined that takes into consideration the interplay of ethical principles and rules at individual, community, national, and global levels. Concepts such as the precautionary principle and solidarity are shown to be useful to public health ethics to the extent that they can be shown to provide worthwhile guidance and information above and beyond principles of beneficence, nonmaleficence, and justice, and the clusters of rules and maxims that are linked to these moral principles. Future directions likely to be productive include further work on areas of public health ethics such as public trust, community empowerment, the rights of individuals who are targeted (or not targeted) by public health interventions, individual and community resilience and wellbeing, and further clarification of principles, obligations, and rules in public health disciplines such as environmental science, prevention and control of chronic and infectious diseases, genomics, and global health. PMID:20072707

  13. Ethics and Continuing Medical Education.

    ERIC Educational Resources Information Center

    Felch, William C.

    1986-01-01

    Aspects of ethics and continuing medical education (CME) are discussed in terms of CME consumers (physicians), providers, and others; vacation CME and "brownie points"; marketing and cosponsorship; financial support from industry; and entrepreneurialism. (CT)

  14. Medical ethics surveillance in the Armed Forces.

    PubMed

    Pearn, J

    2000-05-01

    Modern defense services depend on a policy of the vigorous promotion of research to ensure that they retain an advantage in any future operational context. Research involving personnel within the armed forces, however, has certain constraints with respect to contemporary, best-practice medical ethics. Service members are one example of a class of "captive subjects" who require special protection in the context of medical research. (Prisoners, students, children, and the intellectually disabled are other such examples.) The majority of national defense forces now have ethical watchdog groups--institutional ethics committees--that oversee research involving service members. Such groups monitor the special considerations and constraints under which subjects in uniform can volunteer for biological research. These committees audit particularly the ethical themes of confidentiality, equality, and justice. Themes inherent in medical research in the military include the standard Beauchamp-Childress paradigm of autonomy, beneficence, nonmaleficence, and justice, to which are added the traditional military values of loyalty, respect, courtesy, and chivalry. Contemporary thinking is that the general principle of affording service members the opportunity to volunteer for research should be maintained within the constraints of compromised training time, national security, and operational necessity. Most biological research (and its outcome) does not in practice compromise confidentiality or military security. This paper presents an audit of the functioning of one national military medical ethics committee, the Australian Defence Medical Ethics Committee, and presents a discussion of its philosophies and influence within the broader military context. The Australian Defence Medical Ethics Committee believes that most research should, as an a priori condition of approval, be intended for open publication in peer-reviewed journals. PMID:10826381

  15. Violence risk assessment as a medical intervention: ethical tensions

    PubMed Central

    Roychowdhury, Ashimesh; Adshead, Gwen

    2014-01-01

    Risk assessment differs from other medical interventions in that the welfare of the patient is not the immediate object of the intervention. However, improving the risk assessment process may reduce the chance of risk assessment itself being unjust. We explore the ethical arguments in relation to risk assessment as a medical intervention, drawing analogies, where applicable, with ethical arguments raised by general medical investigations. The article concludes by supporting the structured professional judgement approach as a method of risk assessment that is most consistent with the respect for principles of medical ethics. Recommendations are made for the future direction of risk assessment indicated by ethical theory. PMID:25237503

  16. Ethics of the electrified mind: Defining issues and perspectives on the principled use of brain stimulation in medical research and clinical care

    PubMed Central

    Cabrera, Laura Y.; Evans, Emily L.; Hamilton, Roy H.

    2013-01-01

    In recent years, non-pharmacologic approaches to modifying human neural activity have gained increasing attention. One of these approaches is brain stimulation, which involves either the direct application of electrical current to structures in the nervous system or the indirect application of current by means of electromagnetic induction. Interventions that manipulate the brain have generally been regarded as having both the potential to alleviate devastating brain-related conditions and the capacity to create unforeseen and unwanted consequences. Hence, although brain stimulation techniques offer considerable benefits to society, they also raise a number of ethical concerns. In this paper we will address various dilemmas related to brain stimulation in the context of clinical practice and biomedical research. We will survey current work involving deep brain stimulation (DBS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). We will reflect upon relevant similarities and differences between them, and consider some potentially problematic issues that may arise within the framework of established principles of medical ethics: nonmaleficence and beneficence, autonomy, and justice. PMID:23733209

  17. Ethics for Medical Educators: An Overview and Fallacies

    PubMed Central

    Singh, Arjun

    2010-01-01

    Ethics is the rule of right conduct or practice in a profession. The basic principles of ethics are beneficence, justice and autonomy or individual freedom. There is very minor demarcation between ethics and the law. The ethics is promulgated by the professional bodies. All are expected to guide the medical professional in their practice. Medical educators have dual ethical obligations: firstly, to the society at large which expects us to produce competent health professionals, and secondly, to the students under our care. The students observe and copy what their teacher does and his/her role modelling can be a gateway to a student's character building. Due to rapid increase in the number of medical colleges, privatization, and capitalism, ethical issue has become much more relevant and needs to discuss in detail. The present paper discusses the ethics for medical educators in detail with, basic principles, common breaches of ethics and fallacies due to wrong application of ethical principles, and the approach to ethics and methods by which we can prevent and avoid breach of ethics. PMID:21716861

  18. Ethics for medical educators: an overview and fallacies.

    PubMed

    Singh, Arjun

    2010-07-01

    Ethics is the rule of right conduct or practice in a profession. The basic principles of ethics are beneficence, justice and autonomy or individual freedom. There is very minor demarcation between ethics and the law. The ethics is promulgated by the professional bodies. All are expected to guide the medical professional in their practice. Medical educators have dual ethical obligations: firstly, to the society at large which expects us to produce competent health professionals, and secondly, to the students under our care. The students observe and copy what their teacher does and his/her role modelling can be a gateway to a student's character building. Due to rapid increase in the number of medical colleges, privatization, and capitalism, ethical issue has become much more relevant and needs to discuss in detail. The present paper discusses the ethics for medical educators in detail with, basic principles, common breaches of ethics and fallacies due to wrong application of ethical principles, and the approach to ethics and methods by which we can prevent and avoid breach of ethics. PMID:21716861

  19. The new Italian code of medical ethics.

    PubMed Central

    Fineschi, V; Turillazzi, E; Cateni, C

    1997-01-01

    In June 1995, the Italian code of medical ethics was revised in order that its principles should reflect the ever-changing relationship between the medical profession and society and between physicians and patients. The updated code is also a response to new ethical problems created by scientific progress; the discussion of such problems often shows up a need for better understanding on the part of the medical profession itself. Medical deontology is defined as the discipline for the study of norms of conduct for the health care professions, including moral and legal norms as well as those pertaining more strictly to professional performance. The aim of deontology is therefore, the in-depth investigation and revision of the code of medical ethics. It is in the light of this conceptual definition that one should interpret a review of the different codes which have attempted, throughout the various periods of Italy's recent history, to adapt ethical norms to particular social and health care climates. PMID:9279746

  20. Fundamental Ethical Principles in Sports Medicine.

    PubMed

    Devitt, Brian M

    2016-04-01

    In sports medicine, the practice of ethics presents many unique challenges because of the unusual clinical environment of caring for players within the context of a team whose primary goal is to win. Ethical issues frequently arise because a doctor-patient-team triad often replaces the traditional doctor-patient relationship. Conflict may exist when the team's priority clashes with or even replaces the doctor's obligation to player well-being. Customary ethical norms that govern most forms of clinical practice, such as autonomy and confidentiality, are not easily translated to sports medicine. Ethical principles and examples of how they relate to sports medicine are discussed. PMID:26832970

  1. Against medical ethics: a response to Cassell

    PubMed Central

    Seedhouse, David

    1998-01-01

    This paper responds to Dr Cassell's request for a fuller explanation of my argument in the paper, Against medical ethics: a philosopher's view. A distinction is made between two accounts of ethics in general, and the philosophical basis of health work ethics is briefly stated. The implications of applying this understanding of ethics to medical education are discussed. PMID:11645072

  2. A Medical Ethics Assessment of the Case of Terri Schiavo

    ERIC Educational Resources Information Center

    Preston, Tom; Kelly, Michael

    2006-01-01

    The social, legal, and political discussion about the decision to stop feeding and hydration for Terri Schiavo lacked a medical ethics assessment. The authors used the principles of medical indications, quality of life, patient preference, and contextual features as a guide to medical decision-making in this case. Their conclusions include the…

  3. Faculty ethics: ideal principles with practical applications.

    PubMed

    Reybold, L Earle

    2009-01-01

    Ethics in higher education is the subject of intense public attention, with considerable focus on faculty roles and responsibilities. Media reports and scholarly research have documented egregious misconduct that includes plagiarism, falsification of data, illicit teacher-student relationships, and grading bias. These accounts of wrongdoing often portray faculty ethicality as only a legal issue of obeying rules and regulations, especially in the teaching and research roles. My discussion challenges this narrow perspective and argues that characterizations of faculty ethicality should take into account broader expectations for professionalism such as collegiality, respect, and freedom of inquiry. First, I review the general principles of faculty ethics developed by the American Association of University Professors, as well as professional codes of ethics in specific professional fields. Second, I juxtapose the experiences of women and minority faculty members in relation to these general codes of ethics. This section examines three issues that particularly affect women and minority faculty experiences of ethicality: "chilly and alienating" academic climates, "cultural taxation" of minority identity, and the snare of conventional reward systems. Third, I suggest practical strategies to reconcile faculty practice with codes of ethics. My challenge is to the faculty as a community of practice to engage professional ethics as social and political events, not just legal and moral failures. PMID:20054074

  4. Ethical principles in critical care medicine.

    PubMed

    Orlowski, J P

    1986-01-01

    This article identifies the ethical principles that have guided medicine since antiquity: beneficence, primum non nocere, patient autonomy, and respect for life and the quality of life. The author's basic premise is that many recently publicized ethical dilemmas are really not dilemmas--the knowledge of what is good or evil is not confused, contradictory, or absent. Instead, medicine's concern and responsibility to its patients is being clouded by legal, governmental, or societal concerns. PMID:3331304

  5. Teaching medical ethics in a medical college in India.

    PubMed

    Ravindran, G D; Kalam, T; Lewin, S; Pais, P

    1997-01-01

    To the best of our knowledge, medical ethics is not taught as a separate subject in Indian medical colleges. St John's Medical College has a programme for teaching medical ethics to its undergraduate students. We describe here the structure of our programme, the syllabus and the teaching methodology. We feel that we have an effective way of teaching medical ethics at our medical college and would encourage other medical colleges to introduce the subject in their curriculum. PMID:9481103

  6. Analysis of medical confidentiality from the islamic ethics perspective.

    PubMed

    Tavaokkoli, Saeid Nazari; Nejadsarvari, Nasrin; Ebrahimi, Ali

    2015-04-01

    Confidentiality is one of the old rules of the medical profession. While emphasizing the necessity of confidentiality in religious teachings, disclosure of other's secrets to commit sin deserves punishment hereafter known. Today, progress in medical science and invention of new diagnostic and therapeutic procedures, as well as the extent of information and disclosure of the secrets of the patients, have provided more than ever. After explaining the concepts and principles of confidentiality in medical ethics, the Islamic-oriented Virtue Ethics, in a comparative review, share the differences in these two sets of ethical review and explain the issue of confidentiality. In professional medical ethics, only the behaviors of health staff are evaluated and moral evaluation of the features cannot be evaluated, but in Islamic ethics, the moral evaluation of the features that are sensual, confidentiality is more stable, without any external supervision will maintain its efficiency. PMID:24272333

  7. The four principles: Can they be measured and do they predict ethical decision making?

    PubMed Central

    2012-01-01

    Background The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. Methods The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. Results Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. Conclusions People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed. PMID:22606995

  8. Medical ethics under managed care.

    PubMed

    Schwartz, P

    1996-01-01

    "Managed Care" is having a profound effect on medical ethics and the patient/physician relationship. Historically, the patient (the first party) contracted with a physician (the second party) to provide medical care. The physician had ethical and legal obligations to the patient. In the "new health care," an employer or the government (the fourth party) or infrequently, the patient (the first party) purchases health care from the HMO, PPO, or similar organization (the third party). The third party then contracts with the physician (the second party) to provide that care. The physician has agreed to two, at times competing and possibly immutably conflicting obligations--one to the patient and one to the third party. The ethical and legal problems that arise from conflict between "the bottom line" and "desired" (appropriate) health care will be difficult to solve. The incompatible duality of physician roles both as patient advocate and manager of limited resources will be further explored, with attention to the enormous pressure being applied to this conflict by society, the law, and the third party. Potential resolutions will be offered. Other ethical problems created by the health care system's conversion to managed care include: CONFIDENTIALITY--Information management is a fundamental underpinning of managed care. With patients switching health care programs frequently, and their enormous size and complexity, careful attention to confidentiality is necessary. INFORMED CONSENT--In addition to informed consent relative to the health care being offered, the patient has a right to know what alternatives might be offered independent of her insurance and payment plan. The patient also has a right to know the economic pressures and arrangements between the second and third parties that could influence the quantity and quality of her health care. QUALITY OF CARE--Managed care contends to be religiously attentive to quality of care. If this is so, the very definition of quality of care may be changing. PMID:8829689

  9. Neuroethics: the pursuit of transforming medical ethics in scientific ethics.

    PubMed

    Figueroa, Gustavo

    2016-01-01

    Ethical problems resulting from brain research have given rise to a new discipline termed neuroethics, representing a new kind of knowledge capable of discovering the neural basis for universal ethics. The article (1) tries to evaluate the contributions of neuroethics to medical ethics and its suitability to outline the foundations of universal ethics, (2) critically analyses the process of founding this universal ethic. The potential benefits of applying neuroimaging, psychopharmacology and neurotechnology have to be carefully weighed against their potential harm. In view of these questions, an intensive dialogue between neuroscience and the humanities is more necessary than ever. PMID:26897168

  10. Medical Students' Affirmation of Ethics Education

    ERIC Educational Resources Information Center

    Lehrmann, Jon A.; Hoop, Jinger; Hammond, Katherine Green; Roberts, Laura Weiss

    2009-01-01

    Objective: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. Methods: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled…

  11. Medical Students' Affirmation of Ethics Education

    ERIC Educational Resources Information Center

    Lehrmann, Jon A.; Hoop, Jinger; Hammond, Katherine Green; Roberts, Laura Weiss

    2009-01-01

    Objective: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. Methods: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled…

  12. The healing philosopher: John Locke's medical ethics.

    PubMed

    Short, Bradford William

    2004-01-01

    This article examines a heretofore unexplored facet of John Locke's philosophy. Locke was a medical doctor and he also wrote about medical issues that are controversial today. Despite this, Locke's medical ethics has yet to be studied. An analysis of Locke's education and his teachers and colleagues in the medical profession, of the 17th century Hippocratic Oath, and of the reaction to the last recorded outbreak of the bubonic plague in London, shines some light on the subject of Locke's medical ethics. The study of Locke's medical ethics confirms that he was a deontologist who opposed all suicide and abortion through much of pregnancy. PMID:15709441

  13. [Ethics and prevention of medicalization].

    PubMed

    Tovar-Bobo, M; Cerecedo-Pérez, M J; Rozadilla-Arias, A

    2013-10-01

    Society has shifted issues of subjective and social reality of the population into the medical field, with the obsession with perfect health becoming a predominant pathogenic factor in the increase in the number of diseases and patients, while the level of health in the population is improving. The power of medicine has made the idea of «medicalising» various aspects of life that can be perceived as medical problems as attractive even when it is not the case. Living entails times of unhappiness and anguish but, should we treat these episodes? We are in the health culture of «everything, here and now». In this article, the ethical implications of unnecessary interventions are analysed, along with the different alternatives that the professionals involved may perform to redirect this situation. It is reflected if we want a world where we all risk wearing labels for this or that disease. PMID:23768567

  14. Medical-Research Ethics under the Microscope.

    ERIC Educational Resources Information Center

    Mangan, Katherine

    2003-01-01

    Discusses the growing involvement between medical schools and medical industries and the ethical problems this situation poses. The main concern is that investigators may expose subjects to unnecessary risks because they are driven by financial motives. (SLD)

  15. Ethical Principles of Psychologists and Code of Conduct.

    ERIC Educational Resources Information Center

    American Psychologist, 2002

    2002-01-01

    Describes the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, focusing on introduction and applicability; preamble; general principles; and ethical standards (resolving ethical issues, competence, human relations, privacy and confidentiality, advertising and other public statements, record keeping and…

  16. [Ethical principles in human scientific research].

    PubMed

    Cruz-Coke, R

    1994-07-01

    Hippocrates was the first physician to use the scientific method to find rational and not religious or mythic causes, for the etiology of diseases. Hippocrates and Aristoteles did not dare to dissect the human body. Afterwards however, many scientists such as Herophilus, Erasitastrus, Vesalus and Fallopio, performed experiments in human beings using vivisection. According to that age's ideas, there was no cruelty in performing vivisection in criminals, since useful knowledge for the progress of medicine and relief of diseases was obtained. Only during the nineteenth century and with Claude Bernard (1865), the ethical principles of systematic scientific research in humans were defined. These principles were violated by nazi physicians during Hitler's dictatorship in Germany (1933-1945). As a response to these horrors, the Ethical Codes of Nuremberg (1947) and Geneva (1948), that reestablished all the strength of Hippocratic principles, were dictated. The Nuremberg rules enact that a research subject must give a voluntary consent, that the experiment must by necessary and exempt of death risk, that the research must be qualified and that the experiment must be discontinued if there is a risk for the subject. The Geneva statement is a modernized hippocratic oath that protects patient's life above all. These classical rules, in force at the present time, are the essential guides that must be applied by physicians and researchers. PMID:7732235

  17. Ethical principles for physician rating sites.

    PubMed

    Strech, Daniel

    2011-01-01

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for physicians that can result from physician rating sites need to be contained without limiting the potential benefits for patients with respect to health, health literacy, and equity. PMID:22146737

  18. [Enhanced recovery after surgery based on medical ethics].

    PubMed

    Zhao, Qingchuan

    2016-03-25

    Enhanced recovery after surgery (ERAS), a new model of perioperative management developed in recent years, can shorten hospital stay, reduce medical cost and postoperative discomfort. However, some of these measures under the strategy are negation of the traditional recommendation and many surgeons are concerned about the medical tangle by the complications coming with the ERAS strategy. In this paper, ERAS strategy is evaluated from an ethical standpoint and the assessment factors of medical behavior are introduced based on medical virtues and medical ethnics. It is also analyzed that how to deal with the conflicts between the textbooks and the ERAS strategy, and elaborated that the medical ethics should be observed if the ERAS strategy is implemented. The scientific principles must be followed, the rights and interests of the patients need to be protected, and the informed consent should be guaranteed. PMID:27003639

  19. Medical internet ethics: a field in evolution.

    PubMed

    Dyer, K A; Thompson, C D

    2001-01-01

    As in any new field, the merger of medicine, e-commerce and the Internet raises many questions pertaining to ethical conduct. Key issues include defining the essence of the patient-provider relationship, establishing guidelines and training for practicing online medicine and therapy, setting standards for ethical online research, determining guidelines for providing quality healthcare information and requiring ethical conduct for medical and health websites. Physicians who follow their professional code of ethics are obligated not to exploit the relationship they have with patients, nor allow anyone else working with them to do so. Physicians and therapists are obligated to serve those who place trust in them for treatment, whether in face-to-face or online Internet encounters with patients or clients. This ethical responsibility to patients and clients is often in direct conflict with the business model of generating profits. Healthcare professionals involved in Medical Internet Ethics need to define the scope of competent medical and healthcare on the Internet. The emerging ethical issues facing medicine on the Internet, the current state of medical ethics on the Internet and questions for future directions of study in this evolving field are reviewed in this paper. PMID:11604935

  20. Preferences for Key Ethical Principles that Guide Business School Students

    ERIC Educational Resources Information Center

    Guyette, Roger; Piotrowski, Chris

    2010-01-01

    Business ethics is presently a major component of the business school curriculum. Although there has been much attention focused on the impact of such coursework on instilling ethical decision-making (Nguyen et al., 2008), there is sparse research on how business students view the major ethical principles that serve as the foundation of business…

  1. Canadian University Ethics Review: Cultural Complications Translating Principles into Practice

    ERIC Educational Resources Information Center

    Tilley, Susan; Gormley, Louise

    2007-01-01

    Drawing from educational research conducted in Canada and Mexico, university researchers explore how culture complicates both the ethics review process and the translation of ethical research principles into practice. University researchers in Canadian contexts seek approval from university Research Ethics Boards to conduct research, following…

  2. Preferences for Key Ethical Principles that Guide Business School Students

    ERIC Educational Resources Information Center

    Guyette, Roger; Piotrowski, Chris

    2010-01-01

    Business ethics is presently a major component of the business school curriculum. Although there has been much attention focused on the impact of such coursework on instilling ethical decision-making (Nguyen et al., 2008), there is sparse research on how business students view the major ethical principles that serve as the foundation of business…

  3. Meningomyelocele in the neonate: medical and ethical considerations.

    PubMed

    Steinberg, A

    1991-03-01

    Whether to treat or not to treat a high neural tube lesion presents a significant ethical dilemma. In the past two decades, the medical practice regarding the approach to a neonate with a neural tube defect has gone through a series of philosophical and therapeutic changes. Medical, ethical, religious, and legal systems have grappled inconclusively with the various aspects of these issues in recent years. In this article, the pros and cons of relevant medical and ethical considerations are analyzed, and a decision-making process is outlined. It is suggested that in order to enhance the ability of the responsible care provider and the parents to reach reasonable and morally defensible decisions, a properly organized decision-making process ought to be adhered to. Each individual patient should be analyzed according to the following major categories: medical data, basic ethical and religious principles, legal and/or institutional regulations, and physician-parents relationship. Based on current medical knowledge and on pertinent ethical reasoning, it is argued and recommended that almost always, if possible, aggressive management should be favored. PMID:2037891

  4. A Systematic Review of Ethical Principles in the Plastic Surgery Literature

    PubMed Central

    Chung, Kevin C.; Pushman, Allison G.; Bellfi, Lillian T.

    2009-01-01

    Background: To perform a systematic review to identify articles that discuss ethical issues relating to the field of plastic and reconstructive surgery and to evaluate whether ethical issues are underrepresented in the plastic surgery literature. Methods: Four medical databases were selected to search through the medical literature with specific inclusion criteria to disqualify irrelevant articles from the study. Appropriate articles were extracted, and their quality and validity were assessed by multiple investigators to maximize reproducibility. The data were then synthesized and analyzed for associations amongst the ethical principles. Results: Out of a total library search of >100,000 plastic surgery oriented articles, only 110 clearly focused on ethical principles. Autonomy (53%) was the most common major theme, whereas distributive justice (15%) represented the least frequently emphasized ethical principle. The proportions of each ethical principle were tested against each other for equality using Cochran's Q test; the Q test reached statistical significance (Q = 67.04, df =3, P < 0.0001), indicating that the ethical principles were not discussed equally in plastic surgery literature, which was expected because autonomy represented 53% of the manuscripts whereas distributive justice represented only 15% of manuscripts. When examining both major and minor themes, over half of the articles (61%) addressed 2 or more ethical principles. Beneficence and nonmaleficence were strongly associated (Pearson's x2 = 55.38, df =1, P<0.0001). Conclusions: Despite the extensive amount of ethical issues that plastic surgeons face, a relatively small proportion of plastic surgery literature was dedicated to discussing ethical principles. PMID:20009860

  5. Is a moral consensus in medical ethics possible?

    PubMed Central

    Mitchell, B.

    1976-01-01

    At the moment in Britain and elsewhere the debate inside and outside of Parliament on various medical issues which are essentially moral never ends. Everybody has his own point of view--or principles. But what emerges for society to adopt can often be called in lay terminology 'compromise'. Professor Mitchell argues in this paper that a moral consensus is possible and indeed ought to be achieved, as today the medical practitioner can no longer make his decision only in accordance with the strict code of ethics of the medical profession. The task of the philosopher, says Professor Mitchell, is to interpret the actions and attitudes demanded by modern medical practice. PMID:957368

  6. Medical ethics as practiced by students, nurses and faculty members in Shiraz University of Medical Sciences

    PubMed Central

    BAZRAFCAN, LEILA; NABEIEI, PARISA; SHOKRPOUR, NASRIN; MOADAB, NEDA

    2015-01-01

    Introduction: Assuming any social role has obligations and fulfilling the related responsibilities has ethical aspects that must be addressed carefully. Each role requires extensive training, which usually takes place in university institutions. Ethics is applied in at least three academic areas, including: a) in education of students' personal growth, b) in patient care, and c) in university communion in population-based health care. Given the importance of this issue in the moral domain, this study examines the correlation among the students, nurses and teacher's opinions regarding principles of medical ethics at Shiraz University of Medical Sciences. Methods: This is a descriptive-analytic and cross-sectional study conducted in 2010. The participants of this research consisted of all medical students, nurses in public hospitals, and faculty members in Shiraz University of Medical Sciences. For validity evaluation, the expert panel method and for reliability evaluation, test-retest method was used. Results: Based on the medical ethics’ scores in these three groups, there was a significant relationship between the mean scores of student-nurses and employed nurses, but there was no significant relationship between those of student-faculties. Also the mean score of the students was the highest in medical ethics. Conclusion: In this study, we presented a list of virtues and moral characteristics of medical staff and found out the method of practicing medical ethics in everyday life of students to improve the moral reasoning of teachers, nurses and students. Moreover, medical ethics, with the presentation of specific criteria for ethical behavior in various domains of human life, especially in dealing with patients, can help practice ethical values in the medical community. PMID:25587553

  7. A model for teaching medical ethics.

    PubMed

    Welbourn, R B

    1985-03-01

    The approach to teaching employed in the Dictionary of Medical Ethics (1) provides a model which might be adopted in other media. Most of the 150 authors were medical, but many represented other disciplines, and they wrote for similar professionals and for the general public. Medical ethics is derived from medical science and practice, moral philosophy, sociology, theology, the law and other disciplines, all of which make essential, distinctive and complementary contributions to knowledge and to teaching. Medical practitioners must play the primary role, because they are responsible for clinical ethical decisions, but they need the co-operation and guidance of others. All who are concerned should work towards the development of a general moral consensus among the profession and public, which keeps abreast of scientific and technical advances and to which all are committed. PMID:3884814

  8. [Medical publications between law and ethics].

    PubMed

    Chadly, Ali

    2004-03-01

    Medical publications are the result of an intellectual inventive effort, yielding legal and ethical questions related to medicine. Copyright's problems in cases of disputed innovation or plagiary are frequent. The Tunisian law has stipulated rules for the original scientific production. Medical publications are also involved in professional liability questions through the reported medical standards. Ethical guidelines recommend that medical research and publications must respect moral rules such as scientific integrity and independence. Respect of such rules must be more guaranteed by ethic committees assessment of the submitted papers. Each medical journal is under obligation towards its readers and must consecrate columns for them to allow exchanges. Transparency must be respected in the field of advertising and supplement issues edition. PMID:15382459

  9. Nurse prescribing ethics and medical marketing.

    PubMed

    Adams, J

    This article suggests that nurse prescribers require an awareness of key concepts in ethics, such as deontology and utilitarianism to reflect on current debates and contribute to them. The principles of biomedical ethics have also been influential in the development of professional codes of conduct. Attention is drawn to the importance of the Association of the British Pharmaceutical Industry's code of practice for the pharmaceutical industry in regulating marketing aimed at prescribers. PMID:21500692

  10. Medical Schools, Clinical Research, and Ethical Leadership

    ERIC Educational Resources Information Center

    Makarushka, Julia L.; Lally, John J.

    1974-01-01

    Recent discussion of the ethical problems of biomedical human experimentation has drawn attention to the responsibility of the medical schools for training new clinical investigators and for safeguarding the rights and welfare of the subjects of clinical research conducted in the medical schools and their affiliated hospitals. (Author)

  11. Medical ethics in a writing of Galen.

    PubMed

    Drizis, Theodore J

    2008-01-01

    The aim of this critical analysis is to present the medical ethics of Galen in his treatise "The Best Physician is Also a Philosopher").Galen opens with the example of Hippocrates as a paradigm of his medical ethics, and continues by saying that the knowledge of the human body must be profound. In the third part of the treatise he stresses the importance of logic, precise use of language, study of the texts by Hippocrates and other medical writings, and dwells on conflicts between theory and medical practice. In the fourth part, he proposes that a physician should have perfect self-control, scorn money and the pleasures of the flesh, and should live a laborious life. Galen's ethics expounded in this treatise outlines ideals a physician should follow, ideals,that have remained valid to this day. PMID:20102254

  12. The ethics of promulgating principles of research ethics: the problem of diversion effects

    PubMed Central

    Wertheimer, Alan

    2015-01-01

    There is an important distinction between ethical standards for the conduct of research with human subjects and the ethics of promulgating principles of research ethics. Those who promulgate ethical standards for the conduct of research have an ethical responsibility to consider the consequences to which those promulgations give rise. In particular, they must consider whether their promulgations will give researchers incentives not to conduct research or not to conduct research in locales in which participants would benefit from participation. I first show how such ‘diversion effects’ are possible and then examine four principles of research ethics in that light. I then consider several objections to the argument that those who promulgate principles of research ethics should consider diversion effects. PMID:25937934

  13. The use of narrative in Jewish medical ethics.

    PubMed

    Jotkowitz, Alan

    2013-09-01

    Anne Jones has pointed out that over the last three decades, stories have been important to medical ethics in at least three ways: (1). Stories as cases for teaching principle-based medical ethics (2). Narratives for moral guides on what is considered living a good life (3). Stories as testimonials written by both patients and physicians. A pioneer in this effort, particularly in regard to using narratives as moral guides, has been the ethicist and philosopher Stanley Hauerwas. Heavily influenced by virtue ethics, Hauerwas believes that it is a person's particular narrative tradition that provides one with convictions that form the basis of one's morality. Befitting a Protestant theologian, he is particularly concerned with the Christian narrative. From a Jewish perspective, there has been much less written on the use of narrative in medical ethics. However, it is a mistake to think that narrative has little, if any, role in Rabbinic ethical decision making. The purpose of this article is to demonstrate the centrality of narrative in the thought of Orthodox Jewish decisors and the problems inherent in this methodology. PMID:22395754

  14. Ethics and maternity care: from principles to practice.

    PubMed

    Lothian, Judith A

    2009-01-01

    In this column, the associate editor of The Journal of Perinatal Education (JPE) discusses the decision to devote an issue of JPE to the ethics of childbirth and maternity care. The current crisis in maternity care mandates a careful look at the ethical principles that provide the foundation for practice. The contents of this special issue include: a broad overview of ethics of childbearing, historical perspectives and contemporary understanding of informed decision making, the ethical issues faced by childbirth educators, and the challenges and moral distress experienced by childbirth educators and other maternity care providers when their values, beliefs, and ethical standards are in conflict with standard maternity care practices. PMID:19415107

  15. Ethical principles and guidelines for the development of cognitive systems.

    SciTech Connect

    Shaneyfelt, Wendy

    2006-05-01

    As cognitive systems technologies emerge, so too do the ethical issues surrounding their development and use. To develop cognitive systems technologies responsibly, Sandia National Laboratories is establishing a framework to proactively address both real and potential ethical issues. This report contains the principles and guidelines developers can use to guide them as they are confronted with ethical issues related to developing cognitive systems technologies as they apply to U.S. national security. A process to apply these principles offers a practical way to transfer these principles from paper to a working strategy. Case studies are presented to reflect upon potential scenarios and to consider resolution strategies.

  16. Is a determination of medical futility ethical?

    PubMed

    Terra, Sandra M; Powell, Suzanne K

    2012-01-01

    Medical futility is a timely topic and one fraught with ethical implications. Medical futility is a term used to describe medical interventions that are expected to result in little or no benefit to a patient. This Editorial examines some considerations and applications of medical futility to a specific patient or treatment, the ramifications of the use of the term futility, and its effects on physician-patient communication and the role of the health care administrator. Invoking medical futility is fraught with areas of vulnerability and implications in ethical decision making. Of concern is whether the treatment will cause more harm than good (nonmaleficence), whether it respects patients' goals and desires (autonomy), and whether the interests of patients, society, and the organization are served (justice). PMID:22488337

  17. Medicine and the Holocaust: a visit to the Nazi death camps as a means of teaching medical ethics in the Israel Defense Forces Medical Corps.

    PubMed

    Oberman, Anthony S; Brosh-Nissimov, Tal; Ash, Nachman

    2010-12-01

    A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the basic tenets of the Geneva Convention. Medical ethics differs from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is 'Witnesses in Uniform' in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions. PMID:21030474

  18. [Bioethics is dead. Long live medical ethics!].

    PubMed

    Barrio Maestre, José María

    2015-01-01

    The purpose of this paper is to show a paradigmatic crisis in academic bioethics. Since an important part of bioethicists began to relativize the ethical prohibition of killing an innocent human being, one way or another they began to ally with the death industry: the business of abortion, and then that of euthanasia. The thesis of this paper is that by crossing that Rubicon bioethics has been corrupted and has lost its connection to the ethical, political and legal discourse. One can only hope that it will revive from its ashes if it retakes the ″taboo″ of the sacredness of human life, something for which medical ethics could provide invaluable help, because it still keeps the notion that ″a doctor should not kill″, although in an excessively ″discreet″ and somehow ″ashamed″ way. However, conscientious doctors know more about ethics than most bioethicists. PMID:26030013

  19. Medical ethics and education for social responsibility.

    PubMed Central

    Roemer, M. I.

    1980-01-01

    The physician, said Henry Sigerist in 1940, has been acquiring an increasingly social role. For centuries, however, codes of medical ethics have concentrated on proper behavior toward individual patients and almost ignored the doctor's responsibilities to society. Major health service reforms have come principally from motivated lay leadership and citizen groups. Private physicians have been largely hostile toward movements to equalize the economic access for people to medical care and improve the supply and distribution of doctors. Medical practice in America and throughout the world has become seriously commercialized. In response, governments have applied various strategies to constrain physicians and induce more socially responsible behavior. But such external pressures should not be necessary if a broad socially oriented code of medical ethics were followed. Health care system changes would be most effective, but medical education could be thoroughly recast to clarify community health problems and policies required to meet them. Sigerist proposed such a new medical curriculum in 1941; if it had been introduced, a social code of medical ethics would not now seem utopian. An international conference might well be convened to consider how physicians should be educated to reach the inspiring goals of the World Health Organization. PMID:7405276

  20. Principles and Ethics for Elementary and Junior High School Teachers

    ERIC Educational Resources Information Center

    Howard, Kiffany

    2010-01-01

    The rules and principles approach for developing educators' ethical judgment may be less effective than a centered approach. A centered approach being one that focuses solely on the elementary and junior high teachers. Educators understand the moral and ethical convolution of their role; possess expertise in interpreting their behavior and…

  1. Impact of destruction of classic moral principles on ethical questions in psychiatry.

    PubMed

    Juki?, Vlado

    2012-10-01

    Society's treatment of psychiatric patients was always a reflection of social development and social awareness, as well as of ethical principles dominating a certain time period in that society. Over the last two and a half millennia, during which principles of Hippocratic ethics applied, attitudes towards psychiatric patients, from an ethical and practical standpoint, were and still are controversial to say the least. During this period thousands of people with mental disorders were abused, tortured, or killed, all of this in accordance to the existing ethical and legislative norms (Malleus Maleficarum, eugenic laws of totalitarian regimes...). In the last forty years many international organizations and associations brought forth a number of resolutions and declarations warning of the position and of the rights of psychiatric patients and giving instructions on the humane, that is to say ethical, treatment of this category of patients. In almost all the western countries laws are passed to protect the rights of people with mental disorders. Thanks to this and maybe even more to the development of psychiatry as a medical and scientific profession, the position of those with mental disorders is improving. However, at the same time over the last 40 years we are witnesses to the destruction of the classic moral principles and the establishment of certain "new" ethics which put psychiatric patients at a disadvantage, only in a more subtle way then before. This is why it is important to reexamine many of the ethical questions in psychiatry in the context of present ethical controversy. PMID:23114806

  2. Ethics Today: Are Our Principles Still Relevant?

    ERIC Educational Resources Information Center

    Garnar, Martin

    2015-01-01

    In 1939 technological advances included the first handheld electric slicing knife, the first mass-produced helicopter, and the first transmission of a picture via a cable system (Science and Technology 2001). That year also saw the first Code of Ethics adopted by the American Library Association (ALA OIF 2010, 311). Can an ethical code first…

  3. Ethics Today: Are Our Principles Still Relevant?

    ERIC Educational Resources Information Center

    Garnar, Martin

    2015-01-01

    In 1939 technological advances included the first handheld electric slicing knife, the first mass-produced helicopter, and the first transmission of a picture via a cable system (Science and Technology 2001). That year also saw the first Code of Ethics adopted by the American Library Association (ALA OIF 2010, 311). Can an ethical code first…

  4. Against the magnanimous in medical ethics.

    PubMed Central

    Kottow, M H

    1990-01-01

    Supererogatory acts are considered by some to be part of medicine, whereas others accept supererogation to be a gratuitous virtue, to be extolled when present, but not to be demanded. The present paper sides with those contending that medicine is duty-bound to benefit patients and that supererogation/altruism must per definition remain outside and beyond any role-description of the profession. Medical ethics should be bound by rational ethics and steer away from separatist views which grant exclusive privileges but also create excessive demands, way beyond what physicians perform or are willing and able to offer. PMID:2231634

  5. Medical Ethics in the Next 25 Years

    PubMed Central

    Tiberius, Richard G.

    1979-01-01

    In the next 10-15 years most of the major ethical dilemmas facing family physicians will grow more acute. This is not to imply that things are getting worse. On the contrary, it is the simultaneous growth of miraculous methods and frightening risks that will make the dilemmas more acute. In the next 15-25 years, we will learn how to minimize the risks. Several major ethical dilemmas of medical practice are reviewed from this perspective. Finally, some issues are considered that do not fit this pattern and that have the potential to become a much greater challenge to humanity. PMID:11662581

  6. The ethics of reality medical television.

    PubMed

    Krakower, Thalia Margalit; Montello, Martha; Mitchell, Christine; Truog, Robert D

    2013-01-01

    Reality medical television, an increasingly popular genre, depicts private medical moments between patients and healthcare providers. Journalists aim to educate and inform the public, while the participants in their documentaries-providers and patients-seek to heal and be healed. When journalists and healthcare providers work together at the bedside, moral problems precipitate. During the summer of 2010, ABC aired a documentary, Boston Med, featuring several Boston hospitals. We examine the ethical issues that arise when journalism and medicine intersect. We provide a framework for evaluating the potential benefits and harms of reality medical television, highlighting critical issues such as informed consent, confidentiality, and privacy. PMID:23631335

  7. [Publicity, ethics and medical deontology].

    PubMed

    Noterman, J

    2011-01-01

    Compatibility between publicity and deontology is an old problem. Since a few months, TV shows, press interviews or newspapers have aroused interest. Some judgements from the European Court and the National Council of the medical Order and lawmakers were expressed. An "inventory of fixtures" seems to be now necessary. PMID:22279855

  8. Medical humanities: an aid to ethical discussions.

    PubMed Central

    Moore, A R

    1977-01-01

    'The ethical landscape', the title given to part of a course devised by Mr. Moore, is described in full in this paper. The whole course is a new adventure in medical education designed to help students to explore the ethical problems in the practice of medicine. The 'ethical landscape' is seen through discussion based on passages from literature depicting doctors' and patients' dilemmas. As the results summarized in the tables show, the students found the course well worth while, and thought that they had gained a new insight into the problems with which they would be confronted and also into their own personalities and those of their fellow students whom previously they had only known superficially. The Chairman of the course, Mr. Moore, was also subjected to assessment from his students, because on the skill of the Chairman such a course would fail or succeed. PMID:870691

  9. Ethical Principles of Psychologists (Amended June 2, 1989).

    ERIC Educational Resources Information Center

    American Psychologist, 1990

    1990-01-01

    Reports the amended ethical principles of psychologists (June 2, 1989). The following principles are covered: (1) responsibility; (2) competence; (3) moral and legal standards; (4) public statements; (5) confidentiality; (6) welfare of the consumer; (7) professional relationships; (8) assessment techniques; (9) research with human participants;…

  10. Ethical Principles of Psychologists (Amended June 2, 1989).

    ERIC Educational Resources Information Center

    American Psychologist, 1990

    1990-01-01

    Reports the amended ethical principles of psychologists (June 2, 1989). The following principles are covered: (1) responsibility; (2) competence; (3) moral and legal standards; (4) public statements; (5) confidentiality; (6) welfare of the consumer; (7) professional relationships; (8) assessment techniques; (9) research with human participants;…

  11. Current trends in medical ethics education.

    PubMed

    Daher, Michel

    2006-01-01

    The unprecedented progress in biomedical sciences and technology during the last few decades has resulted in great transformations in the concepts of health and disease, health systems and healthcare organization and practices. Those changes have been accompanied by the emergence of a broad range of ethical dilemmas that confront the health professionals more frequently in an increasing range of problems and situations. Health care that has been practiced for centuries on the basis of a direct doctor-patient relationship has been increasingly transformed to a more complex process integrating the health-team, the patient (healthcare seeker) and the community. Systematic review of the specialized literature revealed that Healthcare Ethics Education became a basic requirement for any training program for health professionals, and should cover the different stages of undergraduate, postgraduate and continuing education. Both theoretical foundations and practical skills are required for the appropriate ethical reasoning, ethical attitude and decision-making. There is growing evidence that physicians' professional and moral development is not determined by the formal curriculum of ethics, rather more, it is determined by the moral environment of the professional practice, the "hidden curriculum" which deserves serious consideration by medical educators. PMID:17190127

  12. 'Medical ethics'--an alternative approach.

    PubMed Central

    Haldane, J J

    1986-01-01

    Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium. PMID:3761336

  13. Principles for the ethical analysis of clinical and translational research

    PubMed Central

    Gelfond, Jonathan A. L.; Heitman, Elizabeth; Pollock, Brad H.; Klugman, Craig M.

    2013-01-01

    Statistical analysis is a cornerstone of the scientific method and evidence-based medicine, and statisticians serve an increasingly important role in clinical and translational research by providing objective evidence concerning the risks and benefits of novel therapeutics. Researchers rely on statistics and informatics as never before to generate and test hypotheses and to discover patterns of disease hidden within overwhelming amounts of data. Too often, clinicians and biomedical scientists are not adequately proficient in statistics to analyze data or interpret results, and statistical expertise may not be properly incorporated within the research process. We argue for the ethical imperative of statistical standards, and we present ten nontechnical principles that form a conceptual framework for the ethical application of statistics in clinical and translational research. These principles are drawn from the literature on the ethics of data analysis and the American Statistical Association Ethical Guidelines for Statistical Practice. PMID:21751225

  14. Ethical and medical dilemmas of space tourism

    NASA Astrophysics Data System (ADS)

    Marsh, Melinda

    Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.

  15. School Counseling Principles: Ethics and Law

    ERIC Educational Resources Information Center

    Stone, Carolyn

    2006-01-01

    This practical guide will sensitize the professional school counselor to legal and ethical issues involved in working with minors in school settings. Using a case study approach and more than 100 cases representing school counselors daily dilemmas, chapters help the reader connect the reality of school counseling to critical federal and state…

  16. Ethical and Privacy Principles for Learning Analytics

    ERIC Educational Resources Information Center

    Pardo, Abelardo; Siemens, George

    2014-01-01

    The massive adoption of technology in learning processes comes with an equally large capacity to track learners. Learning analytics aims at using the collected information to understand and improve the quality of a learning experience. The privacy and ethical issues that emerge in this context are tightly interconnected with other aspects such as…

  17. Ethical and Privacy Principles for Learning Analytics

    ERIC Educational Resources Information Center

    Pardo, Abelardo; Siemens, George

    2014-01-01

    The massive adoption of technology in learning processes comes with an equally large capacity to track learners. Learning analytics aims at using the collected information to understand and improve the quality of a learning experience. The privacy and ethical issues that emerge in this context are tightly interconnected with other aspects such as…

  18. Militarism, human welfare, and the APA Ethical Principles of Psychologists.

    PubMed

    Summers, Craig

    1992-01-01

    A case study is presented of the American Psychological Association (APA), as a health care organization that promotes human welfare. APA includes policies on human welfare in its Ethical Principles of Psychologists and even lists the advancement of psychology "as a means of promoting human welfare" on its letterhead. Nevertheless, APA has other policies and activities based on military and weapons work that appear to conflict with its promotion of human welfare. Although military work in and of itself may not necessarily be problematic, work that contributes to people purposely being harmed or killed should be squared with the association's ethical guidelines. The results presented here show that this may not be the case: There currently appears to be little justification in the Ethical Principles for work intended to harm people. APA's active lobbying, research, and development for the military are documented here, in relation to an analysis of the Ethical Principles. APA's uncritical support for Operation Desert Storm is examined specifically, with regard to weapons technology and therapeutic treatment of U.S. soldiers on the battlefield. This one-sided support for victims of the war is not in keeping with a Hippocratic health care ethic to treat patients needing care, and to do so with neutrality and impartiality. Similarities to a historical example of nationalistic mental health ethics are discussed, with a review of the development of the German Institute for Psychological Research and Psychotherapy and of the German Society for Psychology in the Nazi wartime effort and the Holocaust. The results here show similar deficiencies in APA's ethical standards, not the least of which is that the code applies to individual members but not to APA policies, committees, or activities. This article concludes with suggested criteria for the Ethical Principles that would at least (a) recognize the ambiguities in systematically developing and using weapons to hurt people and (b) provide an initial rationale of potential justifications. PMID:11651615

  19. Dialectical principlism: an approach to finding the most ethical action.

    PubMed

    Weinstock, Robert

    2015-03-01

    Most forensic psychiatrists occasionally face complex situations in forensic work in which ethics dilemmas cause discomfort. They want to determine the most ethical action, but the best choice is unclear. Fostering justice is primary in forensic roles, but secondary duties such as traditional biomedical ethics and personal values like helping society, combating racism, and being sensitive to cultural issues can impinge on or even outweigh the presumptive primary duty in extreme cases. Similarly, in treatment the psychiatrists' primary duty is to patients, but that can be outweighed by secondary duties such as protecting children and the elderly or maintaining security. The implications of one's actions matter. In forensic work, if the psychiatrist determines that he should not assist the party who wants to hire him, despite evidence clearly supporting its side, the only ethical option becomes not to accept the case at all, because the evidence does not support the better side. Sometimes it can be ethical to accept cases only for one side. In ethics-related dilemmas, I call the method of prioritizing and balancing all types of conflicting principles, duties, and personal and societal values in a dialectic to resolve conflicts among them dialectical principlism. This approach is designed to help determine the most ethical action. It is aspirational and is not intended to get the psychiatrist into trouble. PMID:25770274

  20. The Holocaust and medical ethics: the voices of the victims.

    PubMed

    Jotkowitz, A

    2008-12-01

    Fifty-nine years ago, Dr Leo Alexander published his now famous report on medicine under the Nazis. In his report he describes the two major crimes of German physicians. The participation of physicians in euthanasia and genocide and the horrible experiments performed on concentration camp prisoners in the name of science. In response to this gross violation of human rights by physicians, the Nuremberg military tribunal, which investigated and prosecuted the perpetrators of the Nazi war crimes, established ten principles of ethical conduct in medical research in 1949. Foremost among them was the need for voluntary consent of the human subject and that the experiment be conducted to avoid all unnecessary physical and mental suffering. Notwithstanding all these important efforts and impressive achievements in understanding the ethical failings of Nazi physicians, the bioethical community has almost completely ignored the moral challenges facing the victims of the atrocities. These dilemmas and their responses have continued relevance for modern medicine. PMID:19043111

  1. Medically assisted reproduction and ethical challenges

    SciTech Connect

    Kaeaeriaeinen, Helena . E-mail: helena.kaariainen@utu.fi; Evers-Kiebooms, Gerry; Coviello, Domenico

    2005-09-01

    Many of the ethical challenges associated with medically assisted reproduction are societal. Should the technique be restricted to only ordinary couples or could it be used also to single females or couples of same sex? Should the future child be entitled to know the identity of the gamete donor? Should there be age limits? Can embryos or gametes be used after the death of the donor? Can surrogate mothers be part of the process? Can preimplantation diagnostics be used to select the future baby's sex? In addition, there are several clearly medical questions that lead to difficult ethical problems. Is it safe to use very premature eggs or sperms? Is the risk for some rare syndromes caused by imprinting errors really increased when using these techniques? Do we transfer genetic infertility to the offspring? Is the risk for multiple pregnancies too high when several embryos are implanted? Does preimplantation diagnosis cause some extra risks for the future child? Should the counselling of these couples include information of all these potential but unlikely risks? The legislation and practices differ in different countries and ethical discussion and professional guidelines are still needed.

  2. [Medical research ethics 50 years after Nuremberg].

    PubMed

    Ruyter, K W

    1997-12-10

    50 years ago, in Nuremberg, 23 German doctors were accused of crimes against humanity. The anniversary is a solemn reminder of the dark origins of medical research ethics. Many researchers today believe that the medical experiments carried out under Hitler "vaccinated" postwar researchers against abuse. A review of the practices of postwar research shows that the "vaccination" had limited effect and that there is no reason to believe that the events which took place under Hitler were unique and will never happen again. After the war various measures were introduced to protect research subjects: informed consent, self regulation and independent research ethics committees. The measures have undoubtedly limited the abuse of subjects substantially. Nevertheless, in the Armed Forces, where abuse has been most rampant after the war, informed consent is not always practised and independent review is seldom carried out. With the support of grant institutions, journals and industry the protection of research subjects can be improved. It is recommended that medical faculties arrange an annual commemoration of the victims of medical research in order to raise consciousness and awareness among teachers and students. PMID:9456583

  3. Quality of publication ethics in the instructions to the authors of Iranian journals of medical sciences.

    PubMed

    Salamat, Fatemeh; Sobhani, Abdol-Rasoul; Mallaei, Mahin

    2013-03-01

    Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals) in October 2011. Checklist items (n=15) were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198) were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5%) of the 160 journals were in English and 84 (52.5%) were in Farsi. The most frequently mentioned items related to publication ethics comprised "commitment not to send manuscripts to other journals and re-publish manuscripts" (85%, 83.8%), "aim and scope" of the journal (81.9%), "principles of medical ethics in the use of human samples" (74.4%), and "review process" (74.4%). On the other hand, the items of "principles of advertising" (1.2%), "authorship criteria" (15%), and "integrity in publication of clinical trial results" (30.6%) were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals. PMID:23645959

  4. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    PubMed

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting. PMID:25855946

  5. An Analysis of Student Choices in Medical Ethical Dilemmas.

    ERIC Educational Resources Information Center

    Woloshin, Phyllis Lerman

    This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…

  6. Imparting Medical Ethics: The Role of Mentorship in Clinical Training

    ERIC Educational Resources Information Center

    Rose, Gail L.; Rukstalis, Margaret R.

    2008-01-01

    Mentoring and ethics are integral and intersecting components of medical education. Faculty workloads and diffusion of responsibility for teaching impact both ethics and mentoring. In current academic medical center environments, the expectation that traditional one-on-one mentoring relationships will arise spontaneously between medical students…

  7. An Analysis of Student Choices in Medical Ethical Dilemmas.

    ERIC Educational Resources Information Center

    Woloshin, Phyllis Lerman

    This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…

  8. Imparting Medical Ethics: The Role of Mentorship in Clinical Training

    ERIC Educational Resources Information Center

    Rose, Gail L.; Rukstalis, Margaret R.

    2008-01-01

    Mentoring and ethics are integral and intersecting components of medical education. Faculty workloads and diffusion of responsibility for teaching impact both ethics and mentoring. In current academic medical center environments, the expectation that traditional one-on-one mentoring relationships will arise spontaneously between medical students…

  9. Ethics and Information Technology: Some Principles To Guide Students.

    ERIC Educational Resources Information Center

    Bodi, Sonia

    1998-01-01

    Discusses the ethical challenges of information technology, particularly electronic indexes and the Internet; considers principles to guide students; and discusses possible librarian responses. Topics include Kant's categorical imperative, ownership, right to privacy, social responsibility, self-respect, plagiarism and copyrights, and three…

  10. Some principles of Islamic ethics as found in Harrisian philosophy.

    PubMed

    Aksoy, Sahin

    2010-04-01

    John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a 'deep-look' at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. This may be surprising, or thought of as a 'big' and 'groundless' claim, since John Harris has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). In this study I compare Harrisian teachings with major Islamic principles on 'Responsibility', 'Side-effects and Double-effects', 'Equality', 'Vicious choice, guilt and innocence', 'Organ transplantation and property rights' and 'Advance directives'. PMID:20338934

  11. Principles and Ethics in Scientific Communication in Biomedicine

    PubMed Central

    Donev, Doncho

    2013-01-01

    Introduction and aim: To present the basic principles and standards of scientific communication and writing a paper, to indicate the importance of honesty and ethical approach to research and publication of results in scientific journals, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. Methods: An analysis of relevant materials and documents, sources from the internet and published literature and personal experience and observations of the author. Results: In the past more than 20 years there is an increasingly emphasized importance of respecting fundamental principles and standards of scientific communication and ethical approach to research and publication of results in peer review journals. Advances in the scientific community is based on honesty and equity of researchers in conducting and publishing the results of research and to develop guidelines and policies for prevention and punishment of publishing misconduct. Today scientific communication standards and definitions of fraud in science and publishing are generally consistent, but vary considerably policies and approach to ethics education in science, prevention and penal policies for misconduct in research and publication of results in scientific journals. Conclusion: It is necessary to further strengthen the capacity for education and research, and raising awareness about the importance and need for education about the principles of scientific communication, ethics of research and publication of results. The use of various forms of education of the scientific community, in undergraduate teaching and postgraduate master and doctoral studies, in order to create an ethical environment, is one of the most effective ways to prevent the emergence of scientific and publication dishonesty and fraud. PMID:24505166

  12. General statement of ethical principles and guidelines.

    PubMed

    2010-01-01

    ACHA recognizes that these guidelines are a work in progress and will change as law and professional standards in the field of college health evolve. At this time, ACHA expects that all members actively uphold the principles and guidelines detailed in this document, as guides for conduct in professional activities and situations when breaches in these practices are evident. PMID:20670931

  13. Ethical Questions in Medical Electronic Adherence Monitoring.

    PubMed

    Campbell, Jeffrey I; Eyal, Nir; Musiimenta, Angella; Haberer, Jessica E

    2016-03-01

    Electronic adherence monitors (EAMs) record and report an array of health behaviors, ranging from taking daily medications to wearing medical devices. EAMs are utilized in research worldwide and are being investigated for clinical use. However, there is also growing popular concern about the extent to which electronic devices may be used to monitor individuals, including allegations in the media that EAMs represent a move towards "Big Brother" in medicine. Here, we highlight the unique benefits as well as the potential ethical challenges that electronic adherence monitoring generates. These challenges surround autonomy, privacy and confidentiality, trust, and ancillary care obligations. We describe key questions within each of these domains that warrant further investigation, and present potential solutions to many of the concerns raised. PMID:26358284

  14. Judgement and the role of the metaphysics of values in medical ethics

    PubMed Central

    Thornton, T

    2006-01-01

    Despite its authors' intentions, the four principles approach to medical ethics can become crudely algorithmic in practice. The first section sets out the bare bones of the four principles approach drawing out those aspects of Beauchamp and Childress's Principles of biomedical ethics that encourage this misreading. The second section argues that if the emphasis on the guidance of moral judgement is augmented by a particularist account of what disciplines it, then the danger can be reduced. In the third section, I consider how much the resultant picture diverges from Beauchamp and Childress's actual position. PMID:16731739

  15. Relevance of the rationalist-intuitionist debate for ethics and professionalism in medical education.

    PubMed

    Leffel, G Michael; Oakes Mueller, Ross A; Curlin, Farr A; Yoon, John D

    2015-12-01

    Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no consensus about the primary goals of ethics education. Two prevailing perspectives dominate the literature, constituting what is sometimes referred to as the "virtue/skill dichotomy". The first perspective argues that teaching ethics is a means of providing physicians with a skill set for analyzing and resolving ethical dilemmas. The second perspective suggests that teaching ethics is a means of creating virtuous physicians. The authors argue that this debate about medical ethics education mirrors the Rationalist-Intuitionist debate in contemporary moral psychology. In the following essay, the authors sketch the relevance of the Rationalist-Intuitionist debate to medical ethics and professionalism. They then outline a moral intuitionist model of virtuous caring that derives from but also extends the "social intuitionist model" of moral action and virtue. This moral intuitionist model suggests several practical implications specifically for medical character education but also for health science education in general. This approach proposes that character development is best accomplished by tuning-up (activating) moral intuitions, amplifying (intensifying) moral emotions related to intuitions, and strengthening (expanding) intuition-expressive, emotion-related moral virtues, more than by "learning" explicit ethical rules or principles. PMID:25319836

  16. Antiprogestin drugs: ethical, legal and medical issues.

    PubMed

    Cook, R J; Grimes, D A

    1992-01-01

    RU 486 allows women the choice of a medical rather than a surgical abortion, and, for most women, the choice is one of procedure, not of whether to have an abortion. Issues surrounding RU 486 were explored in an American Society of Law and Medicine conference in December 1991 entitled "Antiprogestin Drugs: Ethical, Legal and Medical Issues." An introduction to 14 conference papers provides an overview of the proceedings. Baulieu, the father of RU 486, described updated developments in its use and the medically supervised method of abortion. Bygdeman and Swahn presented their work in Sweden on combining RU 486 with a prostaglandin to make abortion more effective. They suggested that the drug may be an attractive postovulation contraceptive. Greenslad et al. discussed service delivery aspects of the use of RU 486. Holt considered the implications of use of the drug in low-resource settings. A survey of obstetricians and gynecologists, presented by Heilig, indicates that 22% more physicians would perform a medical abortion. Patient perspectives were addressed by David, who stated that measuring acceptability of an abortion technique is difficult; women have historically used whatever method is available. A collaborative research project in India and Cuba on why women chose certain methods was reported by Winikoff et al. (90% of women would choose medical abortion if faced with the choice again). Berer analyzed French data on women's perspectives on medical vs. surgical abortion. The question of adolescent use of the drug was considered by Senderowitz, who lamented the lack of data on the subject and described what is known about adolescent pregnancy. Macklin proposed a framework for ethical analysis and used facts to address ethical questions. Weinstein provided another ethical framework, to analyze whether pharmacists have a right to refuse to provide abortifacient drugs. Buc approached the subject from a legal point of view and concluded that, whereas legal problems are minimal, political problem are of first concern. Boland described differences in introduction of the drug in France and Britain and the US. The theory of "use it or lose it" in patent legislation is applied differently in the US, France, and the UK. Hayhurst, in a complementary legal analysis, noted that Canadian importation would open access to affluent US women. Pine reported on the legal case Benten vs. Kessler, which did not result in successful importation of the drug for personal use, but resulted in some supportive language from the courts. By refusing to apply to the FDA for marketing approval, RU 486's manufacturer may be setting itself up for a boycott. Approaching the problem from these various perspectives addressed the challenge between medical advances and politics and highlighted the need to balance the benefits to women with perceived threats to values. PMID:1434754

  17. The Precautionary Principle, epidemiology and the ethics of delay.

    PubMed

    Richter, Elihu D; Laster, Richard

    2004-01-01

    Ethics tells us: do good and do no harm and invokes the norms of justice, equity and respect for autonomy in protecting and promoting health and well-being. The Precautionary Principle, a contemporary re-definition of Bradford Hill's case for action, gives us a common sense rule for doing good by preventing harm to public health from delay: when in doubt about the presence of a hazard, there should be no doubt about its prevention or removal. It shifts the burden of proof from showing presence of risk to showing absence of risk, aims to do good by preventing harm, and subsumes the upstream strategies of the Driving Forces Pressure Stress Exposure Effect Action model and downstream strategies from molecular epidemiology for detection and prevention of risk. The Precautionary Principle has emerged because of the ethical import of delays in detection of risks to human health and the environment. Ethical principles, the Precautionary Principle, the DPSEEA model and molecular epidemiology all imply re-emphasizing epidemiology's classic role for early detection and prevention. Delays in recognizing risks from past exposures and acting on the findings (e.g., cigarette smoking and lung cancer, asbestos, organochlorines and endocrine disruption, radiofrequency, raised travel speeds) were examples of failures that were not only scientific, but ethical, since they resulted in preventable harm to exposed populations. These may delay results from, among other things, external and internal determinants of epidemiologic investigations of hazard and risk, including misuse of tests of statistical significance. Furthermore, applying the Precautionary Principle to ensure justice, equity, and respect for autonomy raises questions concerning the short-term costs of implementation to achieve long-term goals and the principles that guide compensation. PMID:15212202

  18. Medical confidentiality: legal and ethical aspects in Greece.

    PubMed

    Papadodima, Stavroula A; Spiliopoulou, Chara A; Sakelliadis, Emmanouil I

    2008-08-01

    Respect for confidentiality is firmly established in codes of ethics and law. Medical care and the patients' trust depend on the ability of the doctors to maintain confidentiality. Without a guarantee of confidentiality, many patients would want to avoid seeking medical assistance The principle of confidentiality, however, is not absolute and may be overridden by public interests. On some occasions (birth, death, infectious disease) there is a legal obligation on the part of the doctor to disclose but only to the appropriate authorities. Permissible disclosure can be granted by the patients' consent, for example, for the purpose of insurance they may wish to take out. Moreover, there are some ambivalent situations (such as criminal acts, or notification of sexual partner in case of a patient with AIDS) for which Greek law does not include relevant provisions, and the Codes of Medical Ethics do not offer clear guidelines. Therefore, the Greek doctor is called to estimate the situation and assume full responsibility for his decision. Finally, new considerations have arisen in the context of the recent advances in the field of telemedicine and electronic archiving. The paper discusses the current situation and legislation in Greece. PMID:18445090

  19. Ethics in medical curriculum; Ethics by the teachers for students and society

    PubMed Central

    Rameshkumar, Karuna

    2009-01-01

    There are many ethical issues involved in the practice of modern medicine. It can be a simple one-on-one issue with complex ramifications. The training of medical ethics should be a continuous process. The ideal time to introduce ethics is a subject of many debates. Though it has to be introduced during the undergraduate curriculum, it requires reinforcing during specialty training also. The teaching of medical ethics can utilize various methodologies. There should be a proper evaluation of the ethical aspects learned. PMID:19881128

  20. Developing an ethical guideline for clinical teaching in Tehran University of Medical Sciences

    PubMed Central

    Hashemi, Akram; Yeketaz, Habibeh; Asghari, Fariba

    2015-01-01

    Clinical education is an essential part of medical trainees’ education process, and curriculum planners agree that it should be based on ethical standards and principles in the medical field. Nevertheless, no explained and codified criteria have been developed for ethics in clinical teaching. This study was aimed to develop an ethical guideline for medical students and teachers as the first and most important step in respecting patients' rights in educational centers. The initial draft included the codes of ethics in clinical education and was developed based on library studies. Subsequently, it was improved through a qualitative study using semi-structured interviews and focus group sessions with medical students, patients, and medical teachers in educational hospitals affiliated to Tehran University of Medical Sciences. The improved draft was reviewed and validated by a medical expert panel to prepare the final draft. The codes derived from this study included patients’ choices and rights in purely educational procedures, and special considerations for a) obtaining informed consent for educational procedures; b) performing procedures on deceased persons, patients under anesthesia and those lacking decision making capacity; c) educational visual recordings of the patients; and d) safety monitoring in clinical education. The guideline developed in this study incorporates codes of ethics into clinical training. Therefore, in addition to providing efficient education, the interests of patients and their rights are respected, and the ethical sensitivity of learners in primacy of patients’ best interests will be preserved and enhanced. PMID:26839679

  1. Internal Medicine Residents' Preferences regarding Medical Ethics Education.

    ERIC Educational Resources Information Center

    Jacobson, Jay A.; And Others

    1989-01-01

    A survey of residents (N=323) in 6 internal medicine programs investigated the topics students wanted included in the medical ethics curriculum and by which of 17 methods they would prefer to be taught. About three-fourths had previous medical ethics instruction, and most wanted more on specific topics, especially legal and end-of-life issues.…

  2. Devotion, Diversity, and Reasoning: Religion and Medical Ethics.

    PubMed

    Dahnke, Michael D

    2015-12-01

    Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively. PMID:26323531

  3. Autonomy, problem-based learning, and the teaching of medical ethics.

    PubMed Central

    Parker, M

    1995-01-01

    Autonomy has been the central principle underpinning changes which have affected the practice of medicine in recent years. Medical education is undergoing changes as well, many of which are underpinned, at least implicitly, by increasing concern for autonomy. Some universities have embarked on graduate courses which utilize problem-based learning (PBL) techniques to teach all areas, including medical ethics. I argue that PBL is a desirable method for teaching and learning in medical ethics. It is desirable because the nature of ethical enquiry is highly compatible with the learning processes which characterize PBL. But it is also desirable because it should help keep open the question of what autonomy really is, and how it should operate within the sphere of medical practice and medical education. PMID:8558546

  4. Medication monitoring and drug testing ethics project.

    PubMed

    Payne, Richard; Moe, Jeffrey L; Sevier, Catherine Harvey; Sevier, David; Waitzkin, Michael

    2015-01-01

    In 2012, Duke University initiated a research project, funded by an unrestricted research grant from Millennium Laboratories, a drug testing company. The project focused on assessing the frequency and nature of questionable, unethical, and illegal business practices in the clinical drug testing industry and assessing the potential for establishing a business code of ethics. Laboratory leaders, clinicians, industry attorneys, ethicists, and consultants participated in the survey, were interviewed, and attended two face-to-face meetings to discuss a way forward. The study demonstrated broad acknowledgment of variations in the legal and regulatory environment, resulting in inconsistent enforcement of industry practices. Study participants expressed agreement that overtly illegal practices sometimes exist, particularly when laboratory representatives and clinicians discuss reimbursement, extent of testing, and potential business incentives with medical practitioners. Most respondents reported directly observing probable violations involving marketing materials, contracts, or, in the case of some individuals, directly soliciting people with offers of clinical supplies and other "freebies." While many study respondents were skeptical that voluntary standards alone would eliminate questionable business practices, most viewed ethics codes and credentialing as an important first step that could potentially mitigate uneven enforcement, while improving quality of care and facilitating preferred payment options for credentialed parties. Many were willing to participate in future discussions and industry-wide initiatives to improve the environment. PMID:25750169

  5. Developing a Questionnaire for Iranian Women’s Attitude on Medical Ethics in Vaginal Childbirth

    PubMed Central

    Mirzaee Rabor, Firoozeh; Taghipour, Ali; Mirzaee, Moghaddameh; Mirzaii Najmabadi, Khadigeh; Fazilat Pour, Masoud; Fattahi Masoum, Seyed Hosein

    2015-01-01

    Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management. PMID:26835464

  6. Good medical ethics, justice and provincial globalism.

    PubMed

    Prah Ruger, Jennifer

    2015-01-01

    The summer 2014 Ebola virus outbreak in Western Africa illustrates global health's striking inequalities. Globalisation has also increased pandemics, and disparate health system conditions mean that where one falls ill or is injured in the world can mean the difference between quality care, substandard care or no care at all, between full recovery, permanent ill effects and death. Yet attention to the normative underpinnings of global health justice and distribution remains, despite some important exceptions, inadequate in medical ethics, bioethics and political philosophy. We need a theoretical foundation on which to build a more just world. Provincial globalism (PG), grounded in capability theory, offers a foundation; it provides the components of a global health justice framework that can guide implementation. Under PG, all persons possess certain health entitlements. Global health justice requires progressively securing this health capabilities threshold for every person. PMID:25516948

  7. Transplant ethics under scrutiny – responsibilities of all medical professionals

    PubMed Central

    Trey, Torsten; Caplan, Arthur L.; Lavee, Jacob

    2013-01-01

    In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249

  8. Considering something 'ELSE': ethical, legal and socio-economic factors in medical imaging and medical informatics.

    PubMed

    Duquenoy, Penny; George, Carlisle; Solomonides, Anthony

    2008-12-01

    The focus on the use of existing and new technologies to facilitate advances in medical imaging and medical informatics (MIMI) is often directed to the technical capabilities and possibilities that these technologies bring. The technologies, though, in acting as a mediating agent alter the dynamics and context of information delivery in subtle ways. While these changes bring benefits in more efficient information transfer and offer the potential of better healthcare, they also disrupt traditional processes and practices which have been formulated for a different setting. The governance processes that underpin core ethical principles, such as patient confidentiality and informed consent, may no longer be appropriate in a new technological context. Therefore, in addition to discussing new methodologies, techniques and applications, there is need for a discussion of ethical, legal and socio-economic (ELSE) issues surrounding the use and application of technologies in MIMI. Consideration of these issues is especially important for the area of medical informatics which after all exists to support patients, healthcare practitioners and inform science. This paper brings to light some important ethical, legal and socio-economic issues related to MIMI with the aim of furthering an interdisciplinary approach to the increasing use of Information and Communication Technologies (ICT) in healthcare. PMID:18649968

  9. Establishing ethics in an organization by using principles.

    PubMed

    Hawks, Val D; Benzley, Steven E; Terry, Ronald E

    2004-04-01

    Laws, codes, and rules are essential for any community, public or private, to operate in an orderly and productive fashion. Without laws and codes, anarchy and chaos abound and the purpose and role of the organization is lost. However, danger is significant, and damage serious and far-reaching when individuals or organizations become so focused on rules, laws, and specifications that basic principles are ignored. This paper discusses the purpose of laws, rules, and codes, to help understand basic principles. With such an understanding an increase in the level of ethical and moral behavior can be obtained without imposing detailed rules. PMID:15152851

  10. Ethics in dentistry: review and critique of Principles of Ethics and Code of Professional Conduct.

    PubMed

    Nash, D A

    1984-10-01

    This paper has reviewed an ethic for the profession of dental medicine, such an ethic being grounded in the classical characteristics of a profession. The Principles and Code of the ADA have been reviewed and critiqued. The following conclusions are drawn: The dental profession and the individual dentist have a duty to recognize the reciprocity of the relationship that exists with society, and the duty of covenantal fidelity. The dentist has a duty to conduct his or her professional life in accordance with the ethical principles rooted in the moral rules. These are the principles of beneficence: autonomy and justice, in both individual and societal contexts. The dentist has a duty to maintain his or her level of knowledge and skill current. The dentist has an obligation to participate in the professional community to help ensure just distribution of society's resources and to share the burden of professional self-regulation to the extent that such a privilege is granted by society. The current Principles and Code are helpful expressions of dentistry's professional obligations, but are deficient in: not speaking to reciprocity of relationship, the principle of self-determination, and not providing for societal participation in the covenant agreement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6384327

  11. What is it to do good medical ethics? From the perspective of a practising doctor who is in Parliament.

    PubMed

    Finlay, Ilora G

    2015-01-01

    This article is a personal reflection on work as a physician with work as a member of the UK Parliament's House of Lords. Ethical thinking should underpin everything we do; the 'four principles' of medical ethics provide an applicable and relevant ethical framework. This article explores its application in both domains of work-as a clinician and as a legislator-with some examples of its use 'to do good medical ethics' in both roles. Debates around tobacco and drug control, pandemic control, abortion and assisted suicide are explored. PMID:25516943

  12. Reflecting on the ethical administration of computerized medical records

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.

    1995-05-01

    This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing staff system training. Administration should develop ways to monitor staff compliance with confidentiality policies and should assess diligence in maintaining patient record confidentiality as part of staff annual performance evaluations. Ethical management of IMAC systems is the business of all members of the health care team. Computerized patient records management (including IMAC) should be scrutinized as any other clinical medial ethical issue. If hospitals include these processes in their planning for RIS, IMACS, and HIS systems, they should have time to develop institutional expertise on these questions before and as systems are installed rather than only as ethical dilemmas develop during their use.

  13. Combination of heterogeneous criteria for the automatic detection of ethical principles on health web sites.

    PubMed

    Gaudinat, Arnaud; Grabar, Natalia; Boyer, Célia

    2007-01-01

    The detection of ethical issues of web sites aims at selection of information helpful to the reader and is an important concern in medical informatics. Indeed, with the ever-increasing volume of online health information, coupled with its uneven reliability and quality, the public should be aware about the quality of information available online. In order to address this issue, we propose methods for the automatic detection of statements related to ethical principles such as those of the HONcode. For the detection of these statements, we combine two kinds of heterogeneous information: content-based categorizations and URL-based categorizations through application of the machine learning algorithms. Our objective is to observe the quality of categorization through URL's for web pages where categorization through content has been proven to be not precise enough. The results obtained indicate that only some of the principles were better processed. PMID:18693839

  14. Combination of Heterogeneous Criteria for the Automatic Detection of Ethical Principles on Health Web sites

    PubMed Central

    Gaudinat, Arnaud; Grabar, Natalia; Boyer, Célia

    2007-01-01

    The detection of ethical issues of web sites aims at selection of information helpful to the reader and is an important concern in medical informatics. Indeed, with the ever-increasing volume of online health information, coupled with its uneven reliability and quality, the public should be aware about the quality of information available online. In order to address this issue, we propose methods for the automatic detection of statements related to ethical principles such as those of the HONcode. For the detection of these statements, we combine two kinds of heterogeneous information: content-based categorizations and URL-based categorizations through application of the machine learning algorithms. Our objective is to observe the quality of categorization through URL’s for web pages where categorization through content has been proven to be not precise enough. The results obtained indicate that only some of the principles were better processed. PMID:18693839

  15. [Complementary medicine--Jewish medical ethics].

    PubMed

    Katz, Yisrae; Schiff, Elad

    2011-08-01

    In Israel, as in the Western world, the use of different methods of complementary and alternative medicine ICAM) is spreading. CAM raises ethical questions of concern to healthcare providers and to the public: Can physicians recommend a treatment that has no scientific evidence? Should the government include such therapies in the health budget? Can complementary therapists receive protection against lawsuits if their treatment is recognized? The purpose of this article is to present a Jewish perspective on these issues. The fundamental sources that deal with the subject are based on the approach of rabbinic authorities toward unproven medicine, as expressed in the "Mishnah" and "Talmud" (200-500 C.E). The great Jewish scholar who discusses the subject in detail is Maimonides (1135-1204), who defines what "medicine" is and claims that medicine has to rely on reason or experience. Contemporary Jewish commentators present their position based on the interpretation of Maimonides' texts. In this article we claim that treatments can be divided into four groups, each group having a different halachic status: (1) Treatment that might be dangerous--should not be used. (2) Treatment that is safe--can be used, but has no other special status. (3) Treatment recognized by alternative therapists--has consequences for the observant Jew, such as laws of Kashrut and Shabbat. (4) Treatment that was tested and proven using modern medical methods has public significance--the therapist is entitled to legal defense if he made a reasonable mistake; the government can consider funding such treatment using public money. This article presents the Jewish halachic sources upon which we propose an ethical-practical approach to CAM. PMID:21939123

  16. The Development and Teaching of the Ethical Principles and Guidelines for Family Scientists.

    ERIC Educational Resources Information Center

    Adams, Rebecca A.; Dollahite, David C.; Gilbert, Kathleen R.; Keim, Robert E.

    2001-01-01

    Describes the development of the Ethical Principles and Guidelines for Family Scientists that the National Council on Family Relations Board of Directors unanimously approved. Discusses the importance of ethics education for family professionals, provides suggestions for educators, and delineates the ethical principles and guidelines. (Contains 33…

  17. In search of an ethic of medical librarianship.

    PubMed Central

    Crawford, H

    1978-01-01

    Why is the literature on the ethics of librarianship so sparse? Some of the codes of ethics proposed or officially adopted during this century are examined, with an informal commentary on the reasons why they seem to have aroused so little sustained interest and discussion. Attention is directed particularly to library--user relationships and to some of the unique ethical situations in medical libraries. PMID:678701

  18. Adab and its significance for an Islamic medical ethics.

    PubMed

    Sartell, Elizabeth; Padela, Aasim I

    2015-09-01

    Discussions of Islamic medical ethics tend to focus on Sharī'ah-based, or obligation-based, ethics. However, limiting Islamic medical ethics discourse to the derivation of religious duties ignores discussions about moulding an inner disposition that inclines towards adherence to the Sharī'ah. In classical Islamic intellectual thought, such writings are the concern of adab literature. In this paper, we call for a renewal of adabi discourse as part of Islamic medical ethics. We argue that adab complements Sharī'ah-based writings to generate a more holistic vision of Islamic medical ethics by supplementing an obligation-based approach with a virtue-based approach. While Sharī'ah-based medical ethics focuses primarily on the moral status of actions, adab literature adds to this genre by addressing the moral formation of the agent. By complementing Sharī'ah-based approaches with adab-focused writings, Islamic medical ethics discourse can describe the relationship between the agent and the action, within a moral universe informed by the Islamic intellectual tradition. PMID:25934319

  19. Ethics by opinion poll? The functions of attitudes research for normative deliberations in medical ethics.

    PubMed

    Salloch, Sabine; Vollmann, Jochen; Schildmann, Jan

    2014-09-01

    Empirical studies on people's moral attitudes regarding ethically challenging topics contribute greatly to research in medical ethics. However, it is not always clear in which ways this research adds to medical ethics as a normative discipline. In this article, we aim to provide a systematic account of the different ways in which attitudinal research can be used for normative reflection. In the first part, we discuss whether ethical judgements can be based on empirical work alone and we develop a sceptical position regarding this point, taking into account theoretical, methodological and pragmatic considerations. As empirical data should not be taken as a direct source for normative justification, we then delineate different ways in which attitudes research can be combined with theoretical accounts of normative justification in the second part of the article. Firstly, the combination of attitudes research with normative-ethical theories is analysed with respect to three different aspects: (a) The extent of empirical data which is needed, (b) the question of which kind of data is required and (c) the ways in which the empirical data are processed within the framework of an ethical theory. Secondly, two further functions of attitudes research are displayed which lie outside the traditional focus of ethical theories: the exploratory function of detecting and characterising new ethical problems, and the field of 'moral pragmatics'. The article concludes with a methodological outlook and suggestions for the concrete practice of attitudinal research in medical ethics. PMID:23632008

  20. [Introduction to the "Guidelines of Medical Ethics" of the Swiss Academy of Medical Sciences].

    PubMed

    Gsell, O

    1980-11-01

    The guidelines of medical ethic are recommendations of the Swiss Academy of Medical Sciences to the medical doctors to overcome the difficulties of medicine and modern technics and social problems. In an introduction the duties of the physician and his behaviour in the hippocratic mind are exposed, without asking for an oath. The recommendations give I. essential rules of international health organisations and II. Medical-ethic guidelines regarding different questions: 1. research examinations on men 2. euthanasia 3. transplantation 4. artificial insemination 5. sterilisation, especially the operative sterilisation of mentally handicapped persons, without acceptation of the so-called forced sterilisation 6. medical-ethical committees. The newly founded medical-ethical commission of the Swiss Academy of Medical Sciences and its organisation with physicians and laymen is explained. Its different functions are: a) answers to inquiries of international or national organisations and of individual persons b) formulation of principal ideas for medical-ethical questions, which will arise also in the future, not only on research, but also on diagnostic, therapeutic or prophylactic problems. These medical-ethical guidelines are formulated in few words to help the medical doctor for a quick consultation. They give a legal ethic. The Swiss Academy of Medical Sciences considers this as one of her tasks: to guard and to guard and to advance ethical devices in medicine. PMID:7470696

  1. Islamic medical ethics in the 20th century.

    PubMed Central

    Rispler-Chaim, V

    1989-01-01

    While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated. PMID:2614792

  2. Scuba Divers with Disabilities Challenge Medical Protocols and Ethics.

    ERIC Educational Resources Information Center

    Lin, Leslie Y.

    1987-01-01

    Persons with disabilities are diving, as are individuals with such conditions as asthma and epilepsy. A review considers relevant medical and ethical implications of such activity among disabled persons. (Author/CB)

  3. The ethics and safety of medical student global health electives

    PubMed Central

    Dell, Evelyn M.; Varpio, Lara; Petrosoniak, Andrew; Gajaria, Amy

    2014-01-01

    Objectives To explore and characterize the ethical and safety challenges of global health experiences as they affect medical students in order to better prepare trainees to face them. Methods Semi-structured interviews were conducted with 23 Canadian medical trainees who had participated in global health experiences during medical school. Convenience and snowball sampling were utilized. Using Moustakas’s transcendental phenomenological approach, participant descriptions of ethical dilemmas and patient/trainee safety problems were analyzed. This generated an aggregate that illustrates the essential meanings of global health experience ethical and safety issues faced. Results We interviewed 23 participants who had completed 38 electives (71%, n=27, during pre-clinical years) spend-ing a mean 6.9 weeks abroad, and having visited 23 countries. Sixty percent (n=23) had pre-departure training while 36% (n=14) had post-experience debriefing. Three macro-level themes were identified: resource disparities and provision of care; navigating clinical ethical dilemmas; and threats to trainee safety. Conclusions Medical schools have a responsibility to ensure ethical and safe global health experiences. However, our findings suggest that medical students are often poorly prepared for the ethical and safety dilemmas they encounter during these electives. Medical students require intensive pre-departure training that will prepare them emotionally to deal with these dilemmas. Such training should include discussions of how to comply with clinical limitations. PMID:25341214

  4. Chinese Confucian culture and the medical ethical tradition.

    PubMed

    Guo, Z

    1995-08-01

    The Confucian culture, rich in its contents and great in its significance, exerted on the thinking, culture and political life of ancient China immense influences, unparalleled by any other school of thought or culture. Confucian theories on morality and ethics, with 'goodness' as the core and 'rites' as the norm, served as the 'key notes' of the traditional medical ethics of China. The viewpoints of Confucianism on benevolence and material interests, on good and evil, on kindheartedness, and on character cultivation were all inherited by the medical workers and thus became prominent in Chinese traditional medical ethics. Hence, it is clear that the medical profession and Confucianism have long shared common goals in terms of ethics. Influenced by the excellent Confucian thinking and culture, a rather highly-developed system of Chinese traditional medical ethics emerged with a well-defined basic content, and the system has been followed and amended by medical professionals of all generations throughout Chinese history. This system, just to mention briefly, contains concepts such as the need: to attach great importance to the value of life; to do one's best to rescue the dying and to heal the wounded; to show concern to those who suffer from diseases; to practise medicine with honesty; to study medical skills painstakingly; to oppose a careless style of work; to comfort oneself in a dignified manner; to respect local customs and to be polite; to treat patients, noble or humble, equally, and to respect the academic achievements of others, etc. Of course, at the same time, Confucian culture has its own historical and class limitations, which exerted negative influences on traditional medical ethics. Now, if we are to keep up with the development of modern medicine, a serious topic must be addressed. That is how to retain the essence of our traditional medical ethics so as to maintain historic continuity and yet, at the same time, add on the new contents of medical ethics so as to incorporate modern features into our system. Therefore, when trying to reform medical practice in China, we are faced with the urgent need to inherit and promulgate the essence of Confucian ethics--discarding its obsolete concepts--while at the same time building up the new medical ethics that can meet the requirements of the outside world and the future. PMID:7473645

  5. [Which ethics for medical ethics? Homage to Hans Jonas, 1903-1993].

    PubMed

    Munzarová, Marta

    2014-01-01

    Hans Jonas, one of the greatest philosophers of the 20th century, devoted several studies to the ethics in context with medicine and/or to the new biomedical research. His main thoughts in this field are presented (death and dying, mortality, reflections on experimenting with human subjects - nontherapeutic research, cloning, chimaeras). He was a man of wisdom and his humanity and moral sensibility are a matter of admiration. His ethics is in full consent with ethics and the dignity of medical profession. His ideas are compared (and contrasted) with those of the new bio"ethics". PMID:25370772

  6. Great expectations: teaching ethics to medical students in South Africa.

    PubMed

    Behrens, Kevin Gary; Fellingham, Robyn

    2014-12-01

    Many academic philosophers and ethicists are appointed to teach ethics to medical students. We explore exactly what this task entails. In South Africa the Health Professions Council's curriculum for training medical practitioners requires not only that students be taught to apply ethical theory to issues and be made aware of the legal and regulatory requirements of their profession, it also expects moral formation and the inculcation of professional virtue in students. We explore whether such expectations are reasonable. We defend the claim that physicians ought to be persons of virtuous character, on the grounds of the social contract between society and the profession. We further argue that since the expectations of virtue of health care professionals are reasonable, it is also sound reasoning to expect ethics teachers to try to inculcate such virtues in their students, so far as this is possible. Furthermore, this requires of such teachers that they be suitable role models of ethical practice and virtue, themselves. We claim that this applies to ethics teachers who are themselves not members of the medical profession, too, even though they are not bound by the same social contract as doctors. We conclude that those who accept employment as teachers of ethics to medical students, where as part of their contractual obligation they are expected to inculcate moral values in their students, ought to be prepared to accept their responsibility to be professionally ethical, themselves. PMID:23409954

  7. The literature of medical ethics: Bernard Häring

    PubMed Central

    Soane, Brendan

    1977-01-01

    To the general reader and watcher of television programmes medical ethics may appear to be something new. This is not so, for hundreds of articles and many books have appeared over the last 10 years or so to discuss and analyse the problems arising from the practice of medicine. In this study of two larger works - Medical Ethics and Manipulation - both by Bernard Häring, a Roman Catholic theologian - Father Brendan Soane analyses these in some detail and sets their ideas in the context of what has already been written on the major issues of medical ethics and what is likely to be foremost in discussion in the near future. Many readers of this Journal already have the particular background of knowledge to see the problems in medicine which are in fact ethical but the general reader may require help and enlightenment and this is now provided for a special field within the field. PMID:874983

  8. Cultural context in medical ethics: lessons from Japan.

    PubMed

    Powell, Tia

    2006-01-01

    This paper examines two topics in Japanese medical ethics: non-disclosure of medical information by Japanese physicians, and the history of human rights abuses by Japanese physicians during World War II. These contrasting issues show how culture shapes our view of ethically appropriate behavior in medicine. An understanding of cultural context reveals that certain practices, such as withholding diagnostic information from patients, may represent ethical behavior in that context. In contrast, nonconsensual human experimentation designed to harm the patient is inherently unethical irrespective of cultural context. Attempts to define moral consensus in bioethics, and to distinguish between acceptable and unacceptable variation across different cultural contexts, remain central challenges in articulating international, culturally sensitive norms in medical ethics. PMID:16759415

  9. Cultural context in medical ethics: lessons from Japan

    PubMed Central

    Powell, Tia

    2006-01-01

    This paper examines two topics in Japanese medical ethics: non-disclosure of medical information by Japanese physicians, and the history of human rights abuses by Japanese physicians during World War II. These contrasting issues show how culture shapes our view of ethically appropriate behavior in medicine. An understanding of cultural context reveals that certain practices, such as withholding diagnostic information from patients, may represent ethical behavior in that context. In contrast, nonconsensual human experimentation designed to harm the patient is inherently unethical irrespective of cultural context. Attempts to define moral consensus in bioethics, and to distinguish between acceptable and unacceptable variation across different cultural contexts, remain central challenges in articulating international, culturally sensitive norms in medical ethics. PMID:16759415

  10. Integrating cost awareness with ethics in the undergraduate medical curriculum.

    PubMed

    Garland, M J

    1985-01-01

    The challenge to train medical students in cost awareness regarding medical care led to a program at the Oregon Health Sciences University that integrates concern for costs with medical ethics. Cost awareness is a perspective that balances the physician's ethical obligations toward individual patients with their duties toward society whose pooled resources pay for medical services. The program integrates the subject of cost awareness into major required courses spanning the four-year curriculum. First-year students see costs in the context of an overview of social aspects of medical care. For second-year students, cost awareness is incorporated into training in basic clinical skills. Third- and fourth-year students are shown the bill for one of their patients and analyze their ward experiences from the perspective of resource utilization. Junior and senior students examine the impact of the legal system and professional ethics on health care costs. Elective course work on cost awareness is also available. PMID:3965723

  11. Medical Ethics and Law in Radiologic Technology.

    PubMed

    Matthews, Eric P; Matthews, Tracy M

    2015-01-01

    At every stage of their careers, radiologic technologists and student technologists must adhere to high ethical standards, obey the law, and consistently conduct themselves with professionalism. This article explains how modern health care ethics evolved, focusing on 8 important theorists. It also describes the ethical responsibilities of health care providers and the rights of patients. Important civil rights laws are discussed, focusing on the rights of health care workers as employees. A brief overview of the U.S. legal system follows, including the causes of action that most commonly involve health care professionals. Finally, this article discusses professionalism and its implications for radiologic technologists. PMID:26538219

  12. The ethical basis of the precautionary principle in health care decision making

    SciTech Connect

    Meulen, Ruud H.J. ter . E-mail: r.termeulen@ige.unimaas.nl

    2005-09-01

    This article explores the relation between the precautionary and health care decision making. Decision making in medical practice as well as health policy is characterized by uncertainty. On the level of clinical practice for example, one never knows in advance whether one has made the right diagnosis or has opted for the right treatment. Though medical decisions have a risk on serious harms and burdens, the precautionary principle is not applicable to health care. This principle holds that one should not act when there is no scientific proof that no harms will result from a medical act or a policy decision. However, in clinical practice there is a duty to act. Physicians have an obligation to do good to their patients and have to weigh the benefits against possible harms and burdens. The basis virtue of medical decision making is not avoidance of risks, as stated in the precautionary principle, but the prudent assessment of benefits, burdens, and harms, in relation to other ethical principles like respect for autonomy and justice. The precautionary principle does play a role in health care, but it should never rule medical decision making as an absolute principle. This is not only true for clinical decision making, but also for the area of health policy. Physicians and other health care decision makers need to have knowledge about the possible effects of treatments or the precision of diagnostic procedures in order to reduce harm and promote well-being. Evidence-based medicine may contribute to the wisdom of health care decision makers, but this evidence-based wisdom should always be applied under the guidance of prudence, which is the central virtue of health care decision making.

  13. Evaluation of lectures on medical ethics through students' drawings.

    PubMed

    Hasekura, H; Fukushima, H; Hiraide, K

    1990-01-01

    The authors have encouraged medical students to express their impressions of and reactions to lectures on medical ethics by drawing illustrations on their attendance cards. This gives students a sense of participation in the lecture, and also it provides teachers with useful feedback concerning students' understanding of and interest in the subject. PMID:2300003

  14. 76 FR 81517 - Submission for Review and Comment: “The Menlo Report: Ethical Principles Guiding Information and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... SECURITY Submission for Review and Comment: ``The Menlo Report: Ethical Principles Guiding Information and..., DHS S&T sponsored work on ethics in Information and Communication Technology Research (ICTR). This... privacy issues and applicability of ethics with respect to human subjects in ICTR. Overview of...

  15. [Medical confidentiality and HIV/AIDS. Ethical-legal perspective].

    PubMed

    Rueff, Maria do Céu

    2004-01-01

    This paper deals with the cross-fire between the crimes, respectively, of violation of the professional confidentiality and of transmission of infection disease, by omission, under the Portuguese legal framework, in the case of HIV/AIDS. The conflict of interests and duties for the practitioner, and the difficulty of solving it. Shall the practitioner speak, or shall he/she keep silence when the HIV/AIDS patient refuses to say the truth to his/her sexual partner, with the consequent risk of transmission of infection disease? The point of view of the Human rights. The position of the World Health Organisation (WHO) and of the European Union (EU) in the fight against the discrimination of people affected by HIV/AIDS. The statements of the European Convention on Human Rights (ECHR) concerning the right to privacy and to non-discrimination (even for illness). Possibility of confrontation with the positions represented by: a) the opinion of the National Council of Ethics for the Sciences of Life (CNECV), of 23rd October 2000, required by the Order of the Practitioners; b) the opinion of the Portuguese legal experts; c) the Criminal Law and the Procedural Criminal Law; d) the cases of the English jurisprudence (High Courts). The ethics of responsibility, the crossing of the traditional principles of medicine, bioethics and law, as well as the reinforcing of the medical deontology and the implementing of a deontology of the patient as possible ways to be considered in order to find answers for the problems. PMID:16197857

  16. A robust, particularist ethical assessment of medical tourism.

    PubMed

    Meghani, Zahra

    2011-04-01

    Recently, in increasing numbers, citizens of wealthy nations are heading to poorer countries for medical care. They are traveling to the global South as medical tourists because in their home nations either they cannot get timely medical care or they cannot afford needed treatments. This essay offers a robust, particularist ethical assessment of the practice of citizens of richer nations traveling to poorer countries for healthcare. PMID:20491867

  17. Anatomy research under the knife of medical ethics

    PubMed Central

    Johnson, W. M. S.; Archana, R.; Prathibha, K. M.; Johnson, Priscilla

    2015-01-01

    There is increased awareness and anxiety in conducting research for publication and at the same time ignorance about getting Ethical Committee clearance at least in Anatomy Departments among Basic Medical Sciences. While people are actively presenting papers, collect data, Indian Council for Medical Research guidelines does not cover aspects pertaining to Anatomy oriented research activities. This review article is an eye opener for fraternity in the medical field, especially in anatomy. PMID:26015746

  18. Anatomy research under the knife of medical ethics.

    PubMed

    Johnson, W M S; Archana, R; Prathibha, K M; Johnson, Priscilla

    2015-04-01

    There is increased awareness and anxiety in conducting research for publication and at the same time ignorance about getting Ethical Committee clearance at least in Anatomy Departments among Basic Medical Sciences. While people are actively presenting papers, collect data, Indian Council for Medical Research guidelines does not cover aspects pertaining to Anatomy oriented research activities. This review article is an eye opener for fraternity in the medical field, especially in anatomy. PMID:26015746

  19. [Global aspects of medical ethics: conditions and possibilities].

    PubMed

    Neitzke, G

    2001-01-01

    A global or universal code of medical ethics seems paradoxical in the era of pluralism and postmodernism. A different conception of globalisation will be developed in terms of a "procedural universality". According to this philosophical concept, a code of medical ethics does not oblige physicians to accept certain specific, preset, universal values and rules. It rather obliges every culture and society to start a culture-sensitive, continuous, and active discourse on specific issues, mentioned in the codex. This procedure might result in regional, intra-cultural consensus, which should be presented to an inter-cultural dialogue. To exemplify this procedure, current topics of medical ethics (spiritual foundations of medicine, autonomy, definitions concerning life and death, physicians' duties, conduct within therapeutic teams) will be discussed from the point of view of western medicine. PMID:11475094

  20. Applied Ethics and eHealth: Principles, Identity, and RFID

    NASA Astrophysics Data System (ADS)

    Whitehouse, Diane; Duquenoy, Penny

    The social and ethical implications of contemporary technologies are becoming an issue of steadily growing importance. This paper offers an overview in terms of identity and the field of ethics, and explores how these apply to eHealth in both theory and practice. The paper selects a specific circumstance in which these ethical issues can be explored. It focuses particularly on radio-frequency identifiers (RFID). It ends by discussing ethical issues more generally, and the practice of ethical consideration.

  1. Documentation of torture and the Istanbul Protocol: applied medical ethics.

    PubMed

    Furtmayr, Holger; Frewer, Andreas

    2010-08-01

    The so-called Istanbul Protocol, a Manual on the Effective Investigation and Documentation of Torture and other Cruel, Inhumane or Degrading Treatment or Punishment was adopted by the United Nations soon after its completion in 1999 and since then has become an acknowledged standard for documenting cases of alleged torture and other forms of severe maltreatment. In 2009 the "Forum for medicine and human rights" at the Medical Faculty at the University Erlangen-Nuremburg has provided the first German edition of this manual. The article traces back the development of the protocol taking into account the general background as well as the factual occasion of its initiation. The main ethical and legal principles of the manual are introduced as well as the projects for implementing the rules provided in the protocol that have been carried out so far. From this the urgent need for implementation of the Istanbul Protocol guidelines also in Europe and in German-speaking countries and here not exclusively but especially within asylum procedures becomes clear. PMID:20419473

  2. Medical ethics and the Romanian law. Surrogate decisions regarding life-saving medical interventions

    PubMed Central

    CRI?AN, HORA?IU

    2013-01-01

    Romanian doctors who encounter controversial surrogate decisions such as refusal of life-saving interventions react differently from an ethical perspective. Some do not take into account the surrogates’ rejection of treatment, while others respect and abide by the surrogates’ decision and withhold the refused procedures, forgoing their ethical responsibilities. In this article we will defend the ethical position that doctors should consider and, therefore, thoroughly evaluate the surrogate decisions in cases where the medical intervention is life-saving and the benefits for the patient are significant and certain. The doctors who choose to obey the controversial decisions of surrogates usually invoke the Romanian medical law. In the following we argue that in today’s Romanian medical framework there is a conflict between ethical (professional) obligations and the some of the legal provisions and we provide two ethical arguments, one principlist and one contractualist, that prompt for the overriding of refusals which concern life-saving interventions. PMID:26527966

  3. Thai and American doctors on medical ethics: religion, regulation, and moral reasoning across borders.

    PubMed

    Grol-Prokopczyk, Hanna

    2013-01-01

    Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed. PMID:23177778

  4. Reflexive Principlism as an Effective Approach for Developing Ethical Reasoning in Engineering.

    PubMed

    Beever, Jonathan; Brightman, Andrew O

    2016-02-01

    An important goal of teaching ethics to engineering students is to enhance their ability to make well-reasoned ethical decisions in their engineering practice: a goal in line with the stated ethical codes of professional engineering organizations. While engineering educators have explored a wide range of methodologies for teaching ethics, a satisfying model for developing ethical reasoning skills has not been adopted broadly. In this paper we argue that a principlist-based approach to ethical reasoning is uniquely suited to engineering ethics education. Reflexive Principlism is an approach to ethical decision-making that focuses on internalizing a reflective and iterative process of specification, balancing, and justification of four core ethical principles in the context of specific cases. In engineering, that approach provides structure to ethical reasoning while allowing the flexibility for adaptation to varying contexts through specification. Reflexive Principlism integrates well with the prevalent and familiar methodologies of reasoning within the engineering disciplines as well as with the goals of engineering ethics education. PMID:25697306

  5. Medical ethics at Guantanamo Bay and Abu Ghraib: the problem of dual loyalty.

    PubMed

    Clark, Peter A

    2006-01-01

    Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation or signs of torture. Military medical personnel are placed in a position of a "dual loyalty" conflict. They have to balance the medical needs of their patients, who happen to be detainees, with their military duty to their employer. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. PMID:17144181

  6. Ethical principles of informed consent: exploring nurses' dual role of care provider and researcher.

    PubMed

    Judkins-Cohn, Tanya M; Kielwasser-Withrow, Kiersten; Owen, Melissa; Ward, Jessica

    2014-01-01

    This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher. PMID:24369754

  7. Ethics and the comprehensive application of epistemology in medical practice.

    PubMed

    Phaosavasdi, Sukhit; Taneepanichskul, Surasak; Tannirandorn, Yuen; Uerpairojkit, Boonchai; Thamkhantho, Manopchai; Pruksapong, Chumsak; Kanjanapitak, Aurchart; Phupong, Vorapong

    2005-12-01

    Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model for them to follow. Everyone looks for security in her/his profession. Facts need no proof and reference. People with justice in mind should believe and understand the above mentioned. This leads to the problem of mal distribution of doctors in rural areas, why do doctors live in big cities or wish to be in the private sector? In fact, not many a number of doctors serve in the rural area. About 4-5 of them, their name will be announced yearly as the best rural doctor award. After the big ceremony, lasted not longer than a month, it is hard to remember their name. They are proud to be praised, it pushes them into stress intentionally with all the best of their intelligence and the total of their body strength to work harder in rural. Unfortunately their earning, the security of their profession, the increased chance of being sued, to get caught in the medical litigation, the expenses of their family social status and the study of their children cannot be compared to of those doctors in big city and/or in the private sector. Mal distribution of doctors in remote rural areas has been a persisting unresolved problem in many parts of the world, why not apply the principles of ethics and epistemology? They have been left, untouched forever. PMID:16519004

  8. Ethical challenges in Emergency Medical Services: controversies and recommendations.

    PubMed

    Becker, Torben K; Gausche-Hill, Marianne; Aswegan, Andrew L; Baker, Eileen F; Bookman, Kelly J; Bradley, Richard N; De Lorenzo, Robert A; Schoenwetter, David J

    2013-10-01

    Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. This article describes some of the common situations with ethical underpinnings encountered by EMS personnel and managers including denying or delaying transport of patients with non-emergency conditions, use of lights and sirens for patient transport, determination of medical futility in the field, termination of resuscitation, restriction of EMS provider duty hours to prevent fatigue, substance abuse by EMS providers, disaster triage and difficulty in switching from individual care to mass-casualty care, and the challenges of child maltreatment recognition and reporting. A series of ethical questions are proposed, followed by a review of the literature and, when possible, recommendations for management. PMID:23890578

  9. Continuing medical education for life: eight principles.

    PubMed

    Abrahamson, S; Baron, J; Elstein, A S; Hammond, W P; Holzman, G B; Marlow, B; Taggart, M S; Schulkin, J

    1999-12-01

    Continuing medical education (CME) is being pressured to change in response to increasing and changing educational needs of practicing physicians, fostered by technical innovations, evolution of practice styles, and the reorganization of health care delivery. Leadership in the reform of CME falls primarily to the medical specialty societies in light of their traditional responsibilities for accrediting CME and maintaining professional standards. To address the need for reform, the American College of Obstetricians and Gynecologists in 1997 organized a conference to assemble CME program administrators from several medical specialties and academicians with expertise in postgraduate learning. At the conference, issues facing CME were examined. The authors, who were conference participants, state and explain eight principles that emerged from conference discussions. (For example: "Educational activities should be supportive of and coordinated with the transition to evidence-based medicine.") The principles reflect the interspecialty and interdisciplinary consensus achieved by the conference participants and can serve as useful guideposts for educators as they work to improve CME in their institutions. The authors conclude by noting the need for a more systematic and rigorously analytic approach, where CME content is determined according to assessed needs and CME is evaluated by measuring outcomes; for this to happen, CME educators and faculty must be brought up to date through training, including the use of problem-based learning. CME must also instill collegiality, interaction, and collaboration into the learning environment instead of being a solitary learning activity. Finally, CME must not only emphasize the acquisition of knowledge but also instruct physicians in the process of decision making to help them better use their knowledge as they make clinical judgments. PMID:10619003

  10. 77 FR 38631 - Request for Comments on Ethical Issues Associated with the Development of Medical Countermeasures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-28

    ... surrounding clinical research with children, ethical considerations surrounding pediatric medical countermeasure research, and ethical considerations surrounding emergency access to and use of medical... generated by novel and emerging research in biomedicine and related areas of science and technology....

  11. Black money in white coats: whither medical ethics?

    PubMed

    Chattopadhyay, Subrata

    2008-01-01

    There has been a sea change in the ethos of medicine in India in recent decades. Academic dishonesty of an alarming nature has been reported in medical colleges. Moral degeneration and corruption have engulfed the establishment at the highest level. The head of the Medical Council of India was found guilty of corruption and stripped of his position a few years ago. Many professors in private medical colleges draw a part of their salary as "black"money. There is little discussion on this growing malady within the profession. Professional medical associations have turned a blind eye towards unethical practices; sincere efforts to take a stand on ethical medicine are lacking. Marginalisation of ethics raises questions about the professional integrity, moral sensitivity and social responsibility of practitioners of modern medicine in India. PMID:18630248

  12. Medical ethics and new public management in Sweden.

    PubMed

    Hansson, Sven Ove

    2014-07-01

    In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy. PMID:24887153

  13. [Indication: scientific and ethical basis of medical practice].

    PubMed

    Neitzke, G

    2014-02-01

    The medical indication provides a rational foundation for treatment decisions. An indication can be defined as the reasonable professional judgement that a medical procedure is suitable and useful to reach a specific therapeutic goal with a certain probability. An indication includes empirical, causal and purposive considerations and justifications, and a scrutiny of the individual case. This ensures that medical aspects of the patient, therapeutic goals and evidence-based knowledge are integrated and represented in the indication. An indication justifies a treatment proposal to the patient, which may only be carried out after a procedure of informed consent. Indications can be considered as the ethical basis of treatment decisions and as the heart of professionalism: indications should be used as a professional tool to protect against irrational therapeutic expectations, while ensuring the patient's right for reasonable treatment. In health care that is increasingly shaped by economic constraints, conscientious indications ensure the professional and ethical basis of medical treatment decisions. PMID:24352619

  14. Drones--ethical considerations and medical implications.

    PubMed

    Pepper, Tom

    2012-01-01

    Drones enhance military capability and form a potent element of force protection, allowing humans to be removed from hazardous environments and tedious jobs. However, there are moral, legal, and political dangers associated with their use. Although a time may come when it is possible to develop a drone that is able to autonomously and ethically engage a legitimate target with greater reliability than a human, until then military drones demand a crawl-walk-run development methodology, consent by military personnel for weapon use, and continued debate about the complex issues surrounding their deployment. PMID:22558742

  15. Current principles and practice of ethics and law in perinatal medicine.

    PubMed

    Berceanu, C; Albu, Simona Elena; Bo?, Mihaela; Ghelase, M ?t

    2014-01-01

    One of the most controversial discussion topics in modern bioethics, science or philosophy is represented by the beginning of the individual human life. It is ethically, medically and scientifically correct that the human conception product to be born, so to gain personality and individuality, to be treated as a patient since the intrauterine life. Intrauterine foetal interventions, performed in various therapeutic purposes are still in the experimental stage even in centres with rich experience in perinatal medicine. Progresses truly outstanding are present especially in the prenatal diagnostic methods. Non invasive prenatal testing represents without a doubt a great progress in prenatal diagnosis, but from this point of view, the role of practitioners in the field of perinatal medicine, on counselling and addressing the indication of this test becomes essential. Beyond cultural, national, social or related differences, in perinatal medicine practice is particularly important to respect and permanently reassess the ethical codes. Our paper is targeting to spotlight the essential principles and practice of ethics and law in perinatal medicine nowadays on one hand, and to bring an update review on a controversial topic on the other hand. PMID:25729600

  16. Undergraduate International Medical Electives: Some Ethical and Pedagogical Considerations

    ERIC Educational Resources Information Center

    Hanson, Lori; Harms, Sheila; Plamondon, Katrina

    2011-01-01

    The authors argue that attempts to establish more placements to meet the growing demands of undergraduate medical students in North America for international experiences may be outweighing critical reflection on the ethical issues, curricular content, and pedagogical strategies necessary to support equitable engagements with countries of the…

  17. Undergraduate International Medical Electives: Some Ethical and Pedagogical Considerations

    ERIC Educational Resources Information Center

    Hanson, Lori; Harms, Sheila; Plamondon, Katrina

    2011-01-01

    The authors argue that attempts to establish more placements to meet the growing demands of undergraduate medical students in North America for international experiences may be outweighing critical reflection on the ethical issues, curricular content, and pedagogical strategies necessary to support equitable engagements with countries of the…

  18. Covert medication in psychiatric emergencies: is it ever ethically permissible?

    PubMed

    Hung, Erick K; McNiel, Dale E; Binder, Renée L

    2012-01-01

    Covert administration of medications to patients, defined as the administration of medication to patients without their knowledge, is a practice surrounded by clinical, legal, ethics-related, and cultural controversy. Many psychiatrists would be likely to advocate that the practice of covert medication in emergency psychiatry is not clinically, ethically, or legally acceptable. This article explores whether there may be exceptions to this stance that would be ethical. We first review the standard of emergency psychiatric care. Although we could identify no published empirical studies of covert administration of medicine in emergency departments, we review the prevalence of this practice in other clinical settings. While the courts have not ruled with respect to covert medication, we discuss the evolving legal landscape of informed consent, competency, and the right to refuse treatment. We discuss dilemmas regarding the ethics involved in this practice, including the tensions among autonomy, beneficence, and duty to protect. We explore how differences between cultures regarding the value placed on individual versus family autonomy may affect perspectives with regard to this practice. We investigate how consumers view this practice and their treatment preferences during a psychiatric emergency. Finally, we discuss psychiatric advance directives and explore how these contracts may affect the debate over the practice. PMID:22635297

  19. [Medical and ethical basis for embryo cryopreservation].

    PubMed

    Zegers-Hochschild, Fernando; Crosby, Javier A; Salas, Sofía P

    2014-07-01

    As part of Assisted Reproductive Technologies (ART), the advent of embryo freezing lowered the number of embryos transferred, decreasing multiple births without jeopardizing pregnancy rates. Using vitrification technology, 90% of embryos survive after thawing, producing clinical pregnancy rates similar to those of fresh embryos (41.6%y 44.3% respectively). Furthermore, cumulative pregnancy rates, obtained after transferring fresh plus frozen/thawed embryos, can reach 70%. Frozen embryo transfers (FET) are reported by six of seven institutions, which are part of the Chilean ART registry, and altogether constitute 22.8% of all ART procedures. Increasing use of cryopreservation lowered overall multiple gestations from 33% in 1995 to 23% in 2011, reducing pre term births and perinatal mortality. For many people, embryo freezing generates ethical dilemmas, due to the potential risks to which embryos are exposed, and the uncontrolled accumulation and disposal of human embryos. Scientific evidence today shows that frozen/thawed embryos are not exposed to disproportionate risks, and by hindering its use, both women and their children are exposed to the risks of multiple gestation, repeated cycles of ovarian hormonal stimulation or the impossibility to afford repeated ART cycles. In this article, we provide biomedical, as well as ethical, arguments to sustain that embryo cryopreservation is not only justified but fundamental when offering infertility treatment with ART. PMID:25378009

  20. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria.

    PubMed

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done. PMID:25722776

  1. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria

    PubMed Central

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done. PMID:25722776

  2. Medication-assisted treatment for opioid use disorders in correctional settings: an ethics review.

    PubMed

    Ludwig, Ariel S; Peters, Roger H

    2014-11-01

    Opioid use disorders are a pressing health concern that disproportionately impacts the United States (U.S.) correctional population. Medication-assisted treatment (MAT) is an evidence-based standard of care for opioid use disorders. Despite its availability in the community, MAT and MAT medications (buprenorphine and methadone) are largely unavailable and/or inaccessible for the treatment of opioid use disorders in U.S. prisons and jails. Given that the ethical principles have served as justification for limiting access to MAT on "moral" grounds, this article examines the implications of current correctional policies through the ethical principles of: (1) beneficence/non-maleficence; (2) distributive justice (equivalence-of-care); and (3) autonomy (informed consent). Special attention is paid to the five components of informed consent (capacity, disclosure, understanding, voluntariness, and access), as this facet has been used most often to justify policies that limit access to MAT in the past. Findings highlight that these core ethical principles support the adoption of correctional policies that include MAT. Furthermore, our findings demonstrate that autonomy is maximized during the informed consent process when MAT is available as a treatment option. PMID:25249444

  3. Jewish medical ethics: monetary compensation for donating kidneys.

    PubMed

    Grazi, Richard V; Wolowelsky, Joel B

    2004-03-01

    The Israel Health Ministry is preparing legislation that would allow a person to receive monetary compensation in exchange for donating a kidney for a lifesaving transplant. Such a bill would be the first of its kind, and would seem to establish a policy that is in contrast with both existing international professional ethics and major Christian and Islamic religious ethics. In an attempt to investigate the extent to which such a bill would be consistent with traditional Jewish ethics, we reviewed the opinions of major traditional Jewish ethicists/halakhists, with emphasis on contemporary opinions, and found that compensating an organ donor for his or her time, discomfort, inconvenience, and recovery is fully consistent with traditional Jewish law and ethics. While non-altruistic sale of kidneys might be theoretically ethical from a Jewish perspective, ultimately its ethical status is inextricably connected to solving a series of pragmatic issues, such as creating a system that insures that potential vendors/donors are properly informed and not exploited, controlling and supervising medical screening and support of the donors to insure that their health is not permanently endangered, protecting minors and incompetents, and regulating payments so that they reasonably reflect compensation for pain and suffering. PMID:15055281

  4. Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees.

    PubMed

    Li, Rebecca H; Wacholtz, Mary C; Barnes, Mark; Boggs, Liam; Callery-D'Amico, Susan; Davis, Amy; Digilova, Alla; Forster, David; Heffernan, Kate; Luthin, Maeve; Lynch, Holly Fernandez; McNair, Lindsay; Miller, Jennifer E; Murphy, Jacquelyn; Van Campen, Luann; Wilenzick, Mark; Wolf, Delia; Woolston, Cris; Aldinger, Carmen; Bierer, Barbara E

    2016-04-01

    A novel Protocol Ethics Tool Kit ('Ethics Tool Kit') has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. PMID:26811365

  5. [Bioethics in medical institutions--new custom or help? The example of clinical ethics consultation at a University Medical Center].

    PubMed

    Richter, G

    2014-08-01

    Although ethics committees are well established in the medical sciences for human clinical trials, animal research and scientific integrity, the development of clinical ethics in German hospitals started much later during the first decade of the twenty-first century. Clinical ethics consultation should be pragmatic and problem-centered and can be defined as an ethically qualified and informed conflict management within a given legal framework to deal with and resolve value-driven, normative problems in the care of patients. Clinical ethics consultations enable shared clinical decision-making of all parties (e.g. clinicians, patients, family and surrogates) involved in a particular patient's care. The clinical ethicist does not act as an ethics expert by making independent recommendations or decisions; therefore, the focus is different from other medical consultants. Ethics consultation was first established by healthcare ethics committees (HEC) or clinical ethics consultation (CEC) groups which were called in to respond to an ethically problematic situation. To avoid ethical dilemmas or crises and to act preventively with regard to ethical issues in individual patients, an ethics liaison service is an additional option to ethics case consultations which take place on a regular basis by scheduled ethics rounds during the normal ward rounds. The presence of the ethicist offers some unique advantages: it allows early recognition of even minor ethical problems and accommodates the dynamics of ethical and clinical goal-setting in the course of patient care. Most importantly, regular and non-authoritative participation of the ethicist in normal ward rounds allows continuous ethical education of the staff within the everyday clinical routine. By facilitating clinical ethical decision-making, the ethicist seeks to empower physicians and medical staff to deal appropriately with ethical problems by themselves. Because of this proactive approach, the ethics liaison service can make a significant contribution to preventative ethics in reducing the number of emerging ethical problems to the satisfaction of all parties involved. PMID:24902533

  6. Feminist ethics and menopause: autonomy and decision-making in primary medical care.

    PubMed

    Murtagh, Madeleine J; Hepworth, Julie

    2003-04-01

    The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners' accounts of menopause and treatment in Australia, women's 'choice', 'informed decision-making' and 'empowerment' were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of 'informed decision-making' in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an 'ethic of autonomy' and an 'offer of choice' in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part. PMID:12639581

  7. Medical bribery and the ethics of trust: the Romanian case.

    PubMed

    Manea, Teodora

    2015-02-01

    Medical bribery seems to be a global problem from Eastern Europe and the Balkans to China, a diffuse phenomenon, starting with morally acceptable gratitude and ending with institutional bribery. I focus my attention on Romania and analyze similar cases in Eastern European and postcommunist countries. Medical bribery can be regarded as a particular form of human transaction, a kind of primitive contract that occurs when people do not trust institutions or other forms of social contract that are meant to guarantee their rights and protect their interests. Concluding with strategies to fight medical bribery, I will underline better public policies for financing health and social care, and an ethic of trust that may help to restore trustworthiness of institutions and to rebuild interpersonal trust. This should be complemented by an educational program dedicated to understanding the negative consequences and mechanisms of corruption and the importance of ethical behavior. PMID:25503609

  8. Study of Screen Design Principles for Visualizing Medical Records.

    PubMed

    Fujita, Kenichiro; Takemura, Tadamasa; Kuroda, Tomohiro

    2015-01-01

    To improve UX of EMR/EHR, the screen design principles for the visualization are required. Through the study of common attributes of medical records, we present four principles and show three screen designs by applying them. PMID:26262268

  9. Ethics, Deafness, and New Medical Technologies

    ERIC Educational Resources Information Center

    Hintermair, Manfred; Albertini, John A.

    2005-01-01

    In the last 50 years, several new technologies have become enormously important within the Deaf community and have helped significantly to improve deaf people's lives in a hearing world. Current public attention and admiration, however, seems unduly focused on medical technologies that promise to solve "the problem" of being deaf. One reason for…

  10. Medical and ethical considerations in uterus transplantation.

    PubMed

    Benagiano, Giuseppe; Landeweerd, Laurens; Brosens, Ivo

    2013-11-01

    Transplanting a uterus has unique characteristics, since a successful outcome is represented only by the birth of a viable healthy child. For this reason, critical issues in this type of transplantation differ profoundly from those of other solid organs and, beside a functioning uterus, involve 3 additional steps. First, at the time of implantation, the quality of embryo is tested by specialized decidual cells surrounding the implanting embryo; such testing is aimed at allowing the development of a normal embryo. Second, from early gestation onward, blood supply to the uterus increases from 45 to 750mL per minute. Vascular anastomoses should support such a marked increase in blood flow. Third, full transformation of spiral arterioles in the placental bed is required to direct 75% of the uterine blood flow to the intervillous space. Unfortunately, no suitable animal model is available for experimentation. Three overarching ethical issues must be considered. Should organ transplant be conducted when it is not absolutely necessary as a life-saving or quality-of-life-saving measure? To what extent should medicine delimit its potential in spite of societal desires? Should society demand from medicine the application of whichever technology can be developed and, if so, to what extent? PMID:23987733

  11. Ethics and access to teaching materials in the medical library: the case of the Pernkopf atlas.

    PubMed

    Atlas, M C

    2001-01-01

    Conflicts can occur between the principle of freedom of information treasured by librarians and ethical standards of scientific research involving the propriety of using data derived from immoral or dishonorable experimentation. A prime example of this conflict was brought to the attention of the medical and library communities in 1995 when articles claiming that the subjects of the illustrations in the classic anatomy atlas, Eduard Pernkopf's Topographische Anatomie des Menschen, were victims of the Nazi holocaust. While few have disputed the accuracy, artistic, or educational value of the Pernkopf atlas, some have argued that the use of such subjects violates standards of medical ethics involving inhuman and degrading treatment of subjects or disrespect of a human corpse. Efforts were made to remove the book from medical libraries. In this article, the history of the Pernkopf atlas and the controversy surrounding it are reviewed. The results of a survey of academic medical libraries concerning their treatment of the Pernkopf atlas are reported, and the ethical implications of these issues as they affect the responsibilities of librarians is discussed. PMID:11209801

  12. Ethical challenges in teaching genetics for medical students.

    PubMed

    Nagle, Erika; Kažoka, Dzintra

    2014-12-01

    Although inclusion of ethics as a study course in medical students' curricula is a common practice, special approaches in teaching ethics in the context of genetics should be considered. In the realm of genomics, there are several ethically sensitive topics such as diagnosis of genetic diseases, in vitro fertilization, and identification of genetic susceptibility to common diseases. In addition, in communication with the general public, genetic terms should be used with caution. Demonstration of the phenotypes of affected individuals should be regarded as a particular aspect of teaching genetics. In a description of a patient's phenotype, not only is it necessary to provide scientifically precise characteristics of a patient; voice timbre, facial expression, and body language should also be carefully controlled. Furthermore, in medicine, the theory-practice gap is a problematic aspect, and students often find it difficult to apply knowledge on ethical issues to real situations in clinics. For this purpose, clinical cases are presented during classes and their analysis requires a very respectful attitude on the part of both students and lecturers. For many genetic diseases, evaluation of minor anomalies such as a curved fifth finger, low situated ears, or missing of some teeth is required. Some minor anomalies are found in healthy individuals too, and interpretation of such features must therefore be considered carefully. This article describes our experiences in teaching genetics at Riga Stradinš University, ethical problems faced while teaching genetics, and their solutions. PMID:25574275

  13. A randomized trial of ethics education for medical house officers.

    PubMed

    Sulmasy, D P; Geller, G; Levine, D M; Faden, R R

    1993-09-01

    We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series (Limited Intervention or LI), 25 per cent received lectures and case conferences, with an ethicist in attendance (Extensive Intervention or EI), and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group (3.9 on a 1 to 5 scale) compared to the control group (3.6). Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls (4.0 v 2.8). Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile (EI = 57 per cent, LI = 87 per cent, Controls = 82 per cent). We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. PMID:8230148

  14. Ethical Challenges in Teaching Genetics for Medical Students

    PubMed Central

    Nagle, Erika; Kažoka, Dzintra

    2014-01-01

    Although inclusion of ethics as a study course in medical students’ curricula is a common practice, special approaches in teaching ethics in the context of genetics should be considered. In the realm of genomics, there are several ethically sensitive topics such as diagnosis of genetic diseases, in vitro fertilization, and identification of genetic susceptibility to common diseases. In addition, in communication with the general public, genetic terms should be used with caution. Demonstration of the phenotypes of affected individuals should be regarded as a particular aspect of teaching genetics. In a description of a patient’s phenotype, not only is it necessary to provide scientifically precise characteristics of a patient; voice timbre, facial expression, and body language should also be carefully controlled. Furthermore, in medicine, the theory–practice gap is a problematic aspect, and students often find it difficult to apply knowledge on ethical issues to real situations in clinics. For this purpose, clinical cases are presented during classes and their analysis requires a very respectful attitude on the part of both students and lecturers. For many genetic diseases, evaluation of minor anomalies such as a curved fifth finger, low situated ears, or missing of some teeth is required. Some minor anomalies are found in healthy individuals too, and interpretation of such features must therefore be considered carefully. This article describes our experiences in teaching genetics at Riga Stradinš University, ethical problems faced while teaching genetics, and their solutions. PMID:25574275

  15. Using Basic Ethical Principles to Evaluate Safety Efforts in Transfusion Medicine

    PubMed Central

    Brooks, Jay P.

    2012-01-01

    Pursuit of pharmaceutical purity of the blood in the bag has led to a shrinking donor base and a significantly more expensive product. Decisions regarding new infectious marker testing and donor deferrals have typically been made emphasizing decreasing one specific risk without considering the effect the intervention will have on the overall safety and availability of blood transfusion. Regulations have been formulated by governmental agencies with limited input from the medical community. The decision making process has lacked risk benefit analyses and has not had the robustness associated with spirited discussions. Policies made in this manner may result in certain risks being decreased but can also have adverse unintended consequences. Being guided by the ethical principles of nonmaleficence, beneficence, autonomy, and justice, we need to evaluate our actions in the context of overall blood safety rather than narrowly focusing on any one area. PMID:24089647

  16. Influence of Course in Medical Ethics and Law on Career Plans of Medical Students

    ERIC Educational Resources Information Center

    Cheng, Shi-Yann; Lin, Lih-Hwa; Kao, Chung-Han; Chan, Tzu-Min

    2015-01-01

    Background: The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected behavior and ecology in medical practice. For this reason, we designed integrated courses on ethics and law and conducted a questionnaire-based career plan study to understand whether these issues influence their specialty…

  17. An ethical framework for pharmacy management: balancing autonomy and other principles.

    PubMed

    Glassman, Peter A; Schneider, Paul L; Good, Chester B

    2014-04-01

    Decisions to control pharmaceutical costs can cause conflicts as to what medications are covered. Such conflicts have ethical implications, however implicit, and given this fact, an ethical framework can help address them. In the following commentary, we discuss the more traditional, individual-level ethical considerations likely familiar to most clinicians. We, then, discuss population-level ethical constructs that clinicians may not as readily embrace. We also present a hypothetical cancer-care case to illustrate how imbalances in ethical foci between individual- and population-level constructs may lead to conflicts among health care actors and promote shifts in pharmaceutical decision making away from providers and toward payers, paradoxically reducing provider autonomy and hence patient autonomy. Finally, we propose a more comprehensive ethical framework to help converge individual, payer, and societal interests when making pharmaceutical use decisions. Pharmacists play a crucial role as pharmacy benefits managers and should be familiar with individual- and population-based ethical constructs. PMID:24684637

  18. Bariatric Endocrinology: Principles of Medical Practice

    PubMed Central

    Gonzalez-Campoy, J. Michael; Richardson, Bruce; Gonzalez-Cameron, David; Ebrahim, Ayesha; Strobel, Pamela; Martinez, Tiphani; Blaha, Beth; Ransom, Maria; Quinonez-Weislow, Jessica; Pierson, Andrea; Gonzalez Ahumada, Miguel

    2014-01-01

    Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology—the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements. PMID:24899894

  19. Sexual harassment in the medical profession: legal and ethical responsibilities.

    PubMed

    Mathews, Ben; Bismark, Marie M

    2015-08-17

    Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible. PMID:26268291

  20. Risky Treatments: A Jewish Medical Ethics Perspective

    PubMed Central

    Steinberg, Avraham

    2015-01-01

    The Jewish principle concerning a decision with regard to a dangerous treatment is as following: A patient who is estimated to die within 12 months because of a fatal illness is permitted to undergo a treatment that on the one hand may extend his life beyond 12 months, but on the other hand may hasten his death. There are, however, several limitations to this ruling related to the chances of success with the proposed treatment, the nature of the treatment, whether it is intended to be curative or merely to postpone the danger and death, whether the treatment is absolutely necessary, and others. One is not obligated to undergo a dangerous treatment, but one is permitted to do so. The permissibility to forfeit a short life expectancy in order to achieve more prolonged life applies only with the patient’s consent. That consent is valid and is not considered a form of attempted suicide. Neither is a refusal to submit to treatment considered an act of suicide; the patient has the right to refuse a dangerous procedure. In all situations where a permissive ruling is granted for a patient to endanger his short life expectancy, the ruling should be arrived at after careful reflection and with the approval of the rabbinic authorities acting on the recommendation of the most expert physicians. PMID:26241221

  1. 2010 Amendments to the 2002 "Ethical principles of psychologists and code of conduct".

    PubMed

    2010-01-01

    The following amendments to the 2002 "Ethical Principles of Psychologists and Code of Conduct" (the Ethics Code; American Psychological Association, 2002) were adopted by the APA Council of Representatives at its February 2010 meeting. The changes involve the last two sentences of the final paragraph of the Introduction and Applicability section and Ethical Standards 1.02 and 1.03. The amendments became effective June 1, 2010. A history of these amendments to the Ethics Code is provided in the "Report of the Ethics Committee, 2009" in this issue of the American Psychologist (American Psychological Association, Ethics Committee, 2010). Following are a clean version of the revisions and a version indicating changes from the 2002 language (inserted text is underlined; deleted text is crossed out). PMID:20642307

  2. Should medical students track former patients in the electronic health record? An emerging ethical conflict.

    PubMed

    Brisson, Gregory E; Neely, Kathy Johnson; Tyler, Patrick D; Barnard, Cynthia

    2015-08-01

    Medical students are increasingly using electronic health records (EHRs) in clerkships, and medical educators should seek opportunities to use this new technology to improve training. One such opportunity is the ability to "track" former patients in the EHR, defined as following up on patients in the EHR for educational purposes for a defined period of time after they have left one's direct care. This activity offers great promise in clinical training by enabling students to audit their diagnostic impressions and follow the clinical history of illness in a manner not possible in the era of paper charting. However, tracking raises important questions about the ethical use of protected health information, including concerns about compromising patient autonomy, resulting in a conflict between medical education and patient privacy. The authors offer critical analysis of arguments on both sides and discuss strategies to balance the ethical conflict by optimizing outcomes and mitigating harms. They observe that tracking improves training, thus offering long-lasting benefits to society, and is supported by the principle of distributive justice. They conclude that students should be permitted to track for educational purposes, but only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent, and self-restricting review of records to those essential for training. Lastly, the authors observe that this conflict will become increasingly important with completion of the planned Nationwide Health Information Network and emphasize the need for national guidelines on tracking patients in an ethically appropriate manner. PMID:25565261

  3. History of evolution of the concept of medical ethics.

    PubMed

    Majumdar, Sisir K

    2003-01-01

    "Time present and time past are both perhaps present in time future and time future contained in time past".--Thomas Steams Eliot (1888-1965), Noble Literature Laureate, 1948. History and evolution of the concept of Medical Ethics is the classical example of this poetic expression. Virtually, every human society has some forces of myth to explain the origin of morality. Indian ethics was philosophical from its very birth. In the Vedas (1500 B.C.), ethics was an integral aspect of philosophical and religious speculation about the nature of reality. The Vedas says how people ought to live and is the oldest philosophical literature in the world. It was the first account of philosophical ethics in human history. The old Testament of (c. 200 B.C.) the Hebrew Bible (Greek--ta biblia--"the books") gives account of God giving the Ten Commandments--the oral and written Law engraved on tablets of Stone to Moses around 13th century B.C. on Mount Sinai (Arabic--Gebel Musa) the Mountain near the tip of the Sinai Peninsula in West Asia. PMID:17153793

  4. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research.

    ERIC Educational Resources Information Center

    National Commission for the Proptection of Human Subjects of Biomedical and Behavioral Research, Bethesda, MD.

    Recognizing the complex issues involved in the use of human subjects for research, the authors have outlined three ethical principles and guidelines, distinguished between research and practice, and discussed the application of the principles. In general, practice refers to interventions designed to enhance the well-being of clients and which can…

  5. Unwanted pregnancy--medical and ethical dimensions.

    PubMed

    Ravindran, J

    2003-03-01

    Globally, abortion mortality accounts for approximately 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high maternal mortality and morbidity from abortion tend to occur together. Unplanned and unwanted pregnancies constitute a serious public health responsibility. While fertility has declined by half in developing countries, the motivation to control and space births has risen faster than the rate of contraceptive use. Preventing maternal mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. A range of positive steps has been taken to reduce deaths and morbidity from abortion in a growing number of countries over the past 15 years. Making abortion legal is an essential prerequisite in making it safe. In this respect, changing the law does matter and assertions to the contrary are ill conceived and unsupported in practice. Although, in many countries, trends towards safer abortion have often occurred prior to or in the absence of changes in the law, legal changes need to take place if safety is to be sustained for all women. Religious laws may also require attention when legal change is being contemplated. There are three main ways of approaching this problem: liberalizing the existing law within the penal or criminal code; partially or fully legalizing abortion through a positive law or a court ruling; and decriminalising abortion by taking it out of the law. Women's health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure they receive treatment for complications. Committed doctors can make a difference by providing treatment for abortion complications, interpreting the law in a liberal way and providing safe services where these are legal as well as training providers in the safest techniques to reduce mortality and morbidity. Although law, policy and women's rights are central to this issue, making abortions safe is above all a public health responsibility of governments. Moreover, reducing maternal mortality by making abortions safe is also an important part of the international commitment made in Cairo in 1994 at the ICPD and reaffirmed at the Cairo meeting in 1999. PMID:14556348

  6. Publication ethics and the ghost management of medical publication.

    PubMed

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

    It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored. PMID:19222451

  7. Ethics and access to teaching materials in the medical library.

    PubMed

    Atlas, M C

    2000-01-01

    The American Library Association's Library Bill of Rights states that "Materials should not be excluded because of the origin, background, or views of those contributing to their creation." Medical ethicists question the use of data derived from experimentation that may have involved inhuman and degrading treatment of subjects or disrespect of a human corpse. Thus conflict between the upholding of ethical standards of research and freedom of information occurs. This conflict was brought to attention of the medical and library communities when journal articles purported that the source of the subjects for the illustrations in the classic anatomy atlas, Eduard Pernkopf's Topographische Anatomie des Menschen, were victims of the Nazi holocaust. While there has never been any dispute about the accuracy or educational value of the work, efforts were made to remove the book from medical libraries. Were these efforts a violation of the Library Bill of Rights or is it the responsibility of the library to discard those items that do not meet current standards of medical ethics? Librarians made different choices about what to do with the controversial Pernkopf title. PMID:11143883

  8. Research Experience and Agreement with Selected Ethics Principles from Canada's "Tri-Council Policy Statement--Ethical Conduct for Research Involving Humans"

    ERIC Educational Resources Information Center

    Fahy, Pat; Spencer, Bob

    2004-01-01

    An online survey was conducted of students, instructors, and researchers in distance education regarding principles for the ethical treatment of human research subjects. The study used an online questionnaire based on principles drawn from Canada's "Tri-Council Policy Statement, Ethical Conduct for Research Involving Humans" (TCPS, 2003), which…

  9. An analytic approach to resolving problems in medical ethics.

    PubMed Central

    Candee, D; Puka, B

    1984-01-01

    Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia. PMID:6234395

  10. Genetically engineered livestock: ethical use for food and medical models.

    PubMed

    Garas, Lydia C; Murray, James D; Maga, Elizabeth A

    2015-01-01

    Recent advances in the production of genetically engineered (GE) livestock have resulted in a variety of new transgenic animals with desirable production and composition changes. GE animals have been generated to improve growth efficiency, food composition, and disease resistance in domesticated livestock species. GE animals are also used to produce pharmaceuticals and as medical models for human diseases. The potential use of these food animals for human consumption has prompted an intense debate about food safety and animal welfare concerns with the GE approach. Additionally, public perception and ethical concerns about their use have caused delays in establishing a clear and efficient regulatory approval process. Ethically, there are far-reaching implications of not using genetically engineered livestock, at a detriment to both producers and consumers, as use of this technology can improve both human and animal health and welfare. PMID:25387117

  11. Biotechnology entrepreneurship and ethics: principles, paradigms, and products.

    PubMed

    Kuszler, Patricia C

    2006-09-01

    Biotechnology, whether in the context of new drugs derived from DNA and genetic technology, genetically modified food, or biologics making use of living cells, raises ethical concerns at a variety of different levels. At the research level, there is concern that the very nature of research is being subverted, rather than enhanced, by entrepreneurship. This area of ethical concern has intensified in the United States as a result of the conflicts of interests resulting from the growing alliance between University academia and private industry in the research enterprise. As we travel down the research path into development of a drug or technology, ethical questions arise with respect to protecting human subjects and society from danger and exploitation by researchers. As development gives way to marketing and dissemination of a new product, government regulators are pressed to get drugs and biologics through the regulatory pipeline into the market faster, walking an ethical tightrope between speed and safety. As new biotechnology products enter the market place, doctors and patients traverse yet another tightrope, that between unknown risk and the promise of benefit. And finally, patent protection is increasingly viewed as a unethical culprit in keeping prices high and depriving the global poor from lifesaving drugs and biologics. Bioethics has, to date, been largely a creation of Western research and medicine. As such it is wholly inadequate to respond to the cascade of ethical issues that flow from a vibrant biotechnology industry. And if biotechnology is in its infancy, as most believe, it is crucial that scientists, entrepreneurs and governments engage in dialogue about the ethical and societal questions raised on the road of scientific progress. PMID:17078522

  12. [Terminal medical interventions: psychosocial, medical, ethical and legal aspects].

    PubMed

    Englert, M; Ronson, A; Lossignol, D; Body, J J

    2001-04-01

    We give an overview of the available medical solutions to help a patient with refractory symptoms at the end of his life. Patient "competence" must first be evaluated and, even if their diagnosis is difficult, organic mental disorders and depression must be diagnosed and adequately treated to allow a real, personal and honest dialog. Administration of high doses of morphine is frequently used at the end of life not only to fully relieve pain but also to accelerate death, even if this is not clearly stated. This technique is not devoid of hypocrisy and high doses of morphine can have quite unpleasant side effects. Treatment withdrawal or withholding is generally not sufficient to allow a correct end of life. The arrest of ventilation, dialysis, artificial nutrition and even more hydration must often be coupled with techniques inducing unconsciousness, which makes imprecise the limits between such a "passive" ending of life and "active" euthanasia. The technique of terminal sedation, frequently based on the use of midazolam, has been more recently introduced in some palliative care units. Such a "controlled sedation" is supposed to allow a "natural" death by inducing a profound sleep. In opposition with active euthanasia, which allows a quiet and rapid death at a moment chosen by the patient himself, this technique of "sedation" has an undetermined duration, has legal implications which could be viewed as quite similar as the ones of euthanasia, and, moreover, this prolonged agony can be extremely stressful and distressing for the family. Medical-assisted suicide is allowed in The Netherlands under the same conditions as euthanasia. Death is generally obtained after a few hours but the technique is not always successful and the process of death can sometimes be prolonged and uncomfortable. This technique can nevertheless be preferred by some physicians and patients. As compared to active euthanasia, the proportion of medically-assisted suicides (1/6) is low in The Netherlands. Euthanasia is the only technique able to induce a peaceful and rapid death. The proportion of various techniques to actively induce death is probably quite similar in our country than in The Netherlands but, most of the time, these interventions occur at the very end of life when the patient is no longer able to participate in the decision process and thus occur without his explicit request. We think that, as for all medical decisions, the use of one or the other of these various techniques should be selected after a quiet and free discussion between the patient and his physician, preferably in advance and not in a situation of emergency and panic. PMID:11388029

  13. Ethical, Scientific, and Educational Concerns With Unproven Medications

    PubMed Central

    Pray, W. Steven

    2006-01-01

    Quackery (promotion of products that do not work or have not been proven to work) was once a commonly used term within the pharmacy and medical communities. However, an increasingly anti-scientific national climate culminated in passage of the 1994 Dietary Supplement Health and Education Act, which granted unprecedented legitimacy to “dietary supplements” that had not been scientifically proven to be effective and/or safe. In part, this was facilitated when professional pharmacy magazines and journals published advertisements and articles promoting these unproven medications. Gradually, pharmacy codes of ethics eliminated references to quackery, and some pharmacy organizations seemed to accept the unproven medications they once exhorted the pharmacist not to sell. The profession's shift in attitude toward unproven medications occurred as the medical community at large began to realize the value of evidence-based medicine. Academicians must resist pressure to present unproven therapies as realistic alternatives for medications with scientific proof of safety and efficacy. They must stress the value of evidence-based medicine and urge students and pharmacists to recommend only those medications with evidence-based proof of safety and efficacy. PMID:17332867

  14. How medical students learn ethics: an online log of their learning experiences.

    PubMed

    Johnston, Carolyn; Mok, Jonathan

    2015-10-01

    Medical students experience ethics learning in a wide variety of formats, delivered not just through the taught curriculum. An audit of ethics learning was carried out at a medical school through a secure website over one academic year to determine the quantity and range of medical ethics learning in the undergraduate curriculum and compare this with topics for teaching described by the Institute of Medical Ethics (IME) (2010) and the General Medical Council's (GMC) Tomorrow's Doctors (2009). The online audit captured the participants' reflections on their learning experiences and the impact on their future practice. Results illustrate the opportunistic nature of ethics learning, especially in the clinical years, and highlight the reality of the hidden curriculum for medical students. Overall, the ethics learning was a helpful and positive experience for the participants and fulfils the GMC and IME curriculum requirements. PMID:26179455

  15. Ethical Principles in Practice: Evidence from Participatory Action Research

    ERIC Educational Resources Information Center

    Smith, Liz

    2008-01-01

    A significant challenge for all participants in the autism spectrum disorder participatory action research (ASD PAR) project, including the Ministry of Education, the local project teams (LPT) and mentors, was the lack of availability of a single ethics approval process for the project in its entirety and, in particular, one that could accommodate…

  16. Knowledge and ethical perception regarding organ donation among medical students

    PubMed Central

    2013-01-01

    Background To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan. Methods Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20. Results A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students’ opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P=0.000). Conclusion Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic. PMID:24070261

  17. Teaching medical ethics to meet the realities of a changing health care system.

    PubMed

    Millstone, Michael

    2014-06-01

    The changing context of medical practice--bureaucratic, political, or economic--demands that doctors have the knowledge and skills to face these new realities. Such changes impose obstacles on doctors delivering ethical care to vulnerable patient populations. Modern medical ethics education requires a focus upon the knowledge and skills necessary to close the gap between the theory and practice of ethical care. Physicians and doctors-in-training must learn to be morally sensitive to ethical dilemmas on the wards, learn how to make professionally grounded decisions with their patients and other medical providers, and develop the leadership, dedication, and courage to fulfill ethical values in the face of disincentives and bureaucratic challenges. A new core focus of medical ethics education must turn to learning how to put ethics into practice by teaching physicians to realistically negotiate the new institutional maze of 21st-century medicine. PMID:24802645

  18. Medical education must make room for student-specific ethical dilemmas

    PubMed Central

    St Onge, J

    1997-01-01

    Most contemporary undergraduate courses in medical ethics leave a critical gap unfilled because they fail to address student-specific issues, says third-year student Joye St. Onge. In this article, which won third prize in CMAJs 1996 Dr. William Logie Medical Ethics Essay Contest, St. Onge outlines the importance of discussing student-specific ethical dilemmas and suggests ways to introduce such teaching in medical schools. PMID:9141991

  19. Law and medical ethics in organ transplantation surgery

    PubMed Central

    Woodcock, Tom; Wheeler, Robert

    2010-01-01

    This article in the series describes how UK law and medical ethics have evolved to accommodate developments in organ transplantation surgery. August committees have formulated definitions of the point of death of the person which are compatible with the lawful procurement of functioning vital organs from cadavers. Some of the complexities of dead donor rules are examined. Live donors are a major source of kidneys and the laws that protect them are considered. Financial inducements and other incentives to donate erode the noble concept of altruism, but should they be unlawful? PMID:20501013

  20. Private-sector research ethics: marketing or good conflicts management? The 2005 John J. Conley Lecture on Medical Ethics.

    PubMed

    Dresser, Rebecca

    2006-01-01

    Pharmaceutical companies are major sponsors of biomedical research. Most scholars and policymakers focus their attention on government and academic oversight activities, however. In this article, I consider the role of pharmaceutical companies' internal ethics statements in guiding decisions about corporate research and development (R&D). I review materials from drug company websites and contributions from the business and medical ethics literature that address ethical responsibilities of businesses in general and pharmaceutical companies in particular. I discuss positive and negative uses of pharmaceutical companies' ethics materials and describe shortcomings in the companies' existing ethics programs. To guide employees and reassure outsiders, companies must add rigor, independence, and transparency to their R&D ethics programs. PMID:16699963

  1. How an ethics workshop for preceptors affects medical students.

    PubMed Central

    Hennen, B. K.; Morrissy, J.; Grindrod, A.

    1994-01-01

    OBJECTIVE: To determine whether a workshop on medical ethics attended by family medicine preceptors would affect their students' learning of ethics, and what educational and experiential factors affected the students' learning about ethics. DESIGN: A 3-hour workshop planned by a group of family physicians and ethicists and taught by a faculty member and an ethicist was offered to family physician preceptors. Students entering the clerkship were invited by letter to complete written answers to two clinical papers. Their answers were compared with "ideal" answers based on a weighted composite of the responses of 12 family physicians with a particular interest in ethics. The scores of students assigned to preceptors who had been offered the workshop were compared with those of students assigned to a control group of preceptors. Clerks were also asked about influences on their answers. PARTICIPANTS: The 86 preceptors participating in the family medicine programs at the University of Western Ontario, divided by random selection within geographic clustering into an experimental group of 50 and a control group of 36. Preceptors offered the workshop were considered to be in the experimental group whether or not they attended. The student questionnaire was sent to all students entering the family medicine clerkship program in the academic year 1989-1990 and some in the following year, until sufficient responses were received. Responses were analyzed from 32 clerks in the experimental group and 36 in the control group. MAIN OUTCOME MEASURE: Performance of students whose preceptors were invited to the workshop against performance of students whose preceptors were not invited to the workshop. RESULTS: No significant differences were noted between the performance of students whose preceptors were offered the workshop and those whose preceptors were not. CONCLUSION: The single outcome measure and the volunteer bias make conclusions difficult to draw. Further studies varying interventions and outcome measures are warranted. PMID:8086844

  2. Medical marijuana for HIV-associated sensory neuropathy: legal and ethical issues.

    PubMed

    Larriviere, Daniel G

    2014-10-01

    The number of states legalizing medical marijuana is increasing. Medical marijuana is possibly effective therapy for HIV-associated sensory neuropathy. Despite legalization at the state level, however, the current and contradictory federal drug enforcement policy creates the risk that physicians who recommend medical marijuana to their patients will lose their ability to prescribe medications. The federal-state tension has legal and ethical implications for neurologists who receive a request for medical marijuana from their patients since neurologists must strive to both relieve suffering and obey relevant laws. Recommendation of medical marijuana by neurologists to their patients is ethically permissible but is not ethically mandatory. PMID:25299291

  3. Assessing the Awareness of Egyptian Medical Students about Responsible Conduct of Research and Research Ethics: Impact of an Educational Campaign.

    PubMed

    El-Shinawi, Mohamed; Mohamed, Karim Osama; Fouad, Yousef Ahmed; Fahmy, Yara Mohamed; Asar, Hadeel Abdulwahed; Khalil, Mohamed Gomaa; Anestidou, Lida; El-Kamary, Samer S; Mohamed, Mona Mostafa

    2016-01-01

    This is a quasi-experimental pre-post assessment study utilizing an anonymous self-administered questionnaire to assess Egyptian medical students' awareness about responsible conduct of research (RCR) and research ethics. Students' were assessed before and after an RCR awareness campaign. Our results showed that most of the pre-campaign respondents were not familiar with the basic principles and terms of RCR. An increase in the awareness about RCR across all discussed topics was noted following the campaign. We concluded that an educational awareness campaign is effective in increasing medical students' awareness about RCR and should be incorporated into current medical school curricula in Egypt. PMID:26647065

  4. Medical ethics and the interrogation of Guantanamo 063.

    PubMed

    Miles, Steven H

    2007-04-01

    The controversy over abusive interrogations of prisoners during the war against terrorism spotlights the need for clear ethics norms requiring physicians and other clinicians to prevent the mistreatment of prisoners. Although policies and general descriptions pertaining to clinical oversight of interrogations in United States' war on terror prisons have come to light, there are few public records detailing the clinical oversight of an interrogation. A complaint by the Federal Bureau of Investigation (FBI) led to an Army investigation of an interrogation at the United States prison at Guantanamo Bay. The declassified Army investigation and the corresponding interrogation log show clinical supervision, monitoring and treatment during an interrogation that employed dogs, prolonged sleep deprivation, humiliation, restraint, hypothermia and compulsory intravenous infusions. The interrogation and the involvement of a psychologist, physician and medics violate international and medical norms for the treatment of prisoners. PMID:17454984

  5. Perry v. Louisiana: medical ethics on death row--is judicial intervention warranted?

    PubMed

    Katz, D L

    1991-01-01

    The following note considers the complex case of Perry v. Louisiana, in which the Louisiana Supreme Court ordered an insane defendant on death row to be medicated against his will in order to render him sane, and therefore capable of being executed. In so doing the court pit judicial interests in effecting punishment of certain murderers against the physician's Hippocratic Oath, "first do no harm." In considering this conflict, the note identifies "first do no harm" as a guiding principle, explores the societal values underlying this basic principle, and concludes the judiciary must provide legal support for this medical ethical imperative. Similarly the legal profession must identify its organizing principles, its "first do no harm" proscriptions, and consider the application of those principles in the context of representing the insane. Some of the conflicts confronting the physician in the Perry situation have parallels for the attorney representing an insane client. Should the client be medicated in order to proceed to trial? Is it in the best interests of the client to remain a prisoner of her mental illness rather than to risk the possibility of conviction? How should the attorney address the paradoxical reality that a heavily medicated client may indeed become more lucid without becoming more competent? By publishing this note, the Journal hopes to engender discussion and clarification of the vague and sometimes incoherent guidance offered by the Medical Rules of Professional Responsibility, the Model Code of Professional Conduct, and the Criminal Justice Mental Health Standards for legal work with mentally disturbed clients. PMID:12186078

  6. [Fundamental principles of social work--(also) a contribution to public health ethics].

    PubMed

    Lob-Hüdepohl, A

    2009-05-01

    Social work and public health are different but mutually connected. Both are professions with their own ethical foundations. Despite all differences, they have the same goal: to protect and to enhance the well-being of people. This is, in part, why the fundamental ethical principles of social work are salient for developing public health ethics. As a human rights profession, social work respects the personal autonomy of clients, supports solidarity-based relationships in families, groups or communities, and attempts to uphold social justice in society. Social workers need to adopt special professional attitudes: sensibility for the vulnerabilities of clients, care and attentiveness for their resources and strengths, assistance instead of paternalistic care and advocacy in decision making for clients' well-being when clients are not able to decide for themselves. These fundamental ethical principles are the basis for discussion of special topics of social work ethics as public health ethics, for example, in justifying intervention in individual lifestyles by public services without the participation or consent of the affected persons. PMID:19360384

  7. Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs

    PubMed Central

    Verrinder, Joy M.; Ostini, Remo; Phillips, Clive J. C.

    2016-01-01

    Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students’ preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress. PMID:26934582

  8. Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs.

    PubMed

    Verrinder, Joy M; Ostini, Remo; Phillips, Clive J C

    2016-01-01

    Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students' preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress. PMID:26934582

  9. Weaponizing principles: clinical ethics consultations & the plight of the morally vulnerable.

    PubMed

    Fiester, Autumn M

    2015-06-01

    Internationally, there is an on-going dialogue about how to professionalize ethics consultation services (ECSs). Despite these efforts, one aspect of ECS-competence that has received scant attention is the liability of failing to adequately capture all of the relevant moral considerations in an ethics conflict. This failure carries a high price for the least powerful stakeholders in the dispute. When an ECS does not possess a sophisticated dexterity at translating what stakeholders say in a conflict into ethical concepts or principles, it runs the risk of naming one side's claims as morally legitimate and decrying the other's as merely self-serving. The result of this failure is that one side in a dispute is granted significantly more moral weight and authority than the other. The remedy to this problem is that ECSs learn how to expand the diagnostic moral lens they employ in clinical ethics conflicts. PMID:25257049

  10. A Reply on Behalf of the Relativist to Mark Mason's Justification of Universal Ethical Principles

    ERIC Educational Resources Information Center

    MacKenzie, Jim

    2007-01-01

    Mark Mason, in his "A Justification, After the Postmodern Turn, of Universal Ethical Principles and Educational Ideals" Educational Philosophy and Theory, 37 (2005), attempts to justify transcultural multiculturalism. In this paper I argue that he fails to refute moral relativism, and that multiculturalism as he interprets it is not morally…

  11. The Ethical Principle of Regard for People: Using Dewey's Ideas in Schools

    ERIC Educational Resources Information Center

    Simpson, Douglas J.; Sacken, D. Mike

    2015-01-01

    In this study we analyze Dewey's writings and related literature in order to explain and utilize his ethical principle of regard for one's self, others and social groups. His reflections about consequences, the common good, accountability and responsibility undergo scrutiny too. Moreover, we probe his understanding of affections, interest and…

  12. The Ethical Principle of Regard for People: Using Dewey's Ideas in Schools

    ERIC Educational Resources Information Center

    Simpson, Douglas J.; Sacken, D. Mike

    2015-01-01

    In this study we analyze Dewey's writings and related literature in order to explain and utilize his ethical principle of regard for one's self, others and social groups. His reflections about consequences, the common good, accountability and responsibility undergo scrutiny too. Moreover, we probe his understanding of affections, interest and…

  13. A Reply on Behalf of the Relativist to Mark Mason's Justification of Universal Ethical Principles

    ERIC Educational Resources Information Center

    MacKenzie, Jim

    2007-01-01

    Mark Mason, in his "A Justification, After the Postmodern Turn, of Universal Ethical Principles and Educational Ideals" Educational Philosophy and Theory, 37 (2005), attempts to justify transcultural multiculturalism. In this paper I argue that he fails to refute moral relativism, and that multiculturalism as he interprets it is not morally…

  14. [Nursing care as an ethical problem: concepts and principles applied to the act of caring].

    PubMed

    Miranda, Alejandro; Contreras, Sebastián

    2014-01-01

    In this paper the authors study the nature of the act of care, emphasize the importance of ethics in the professions related to the health of people and develop, in the light of the central tradition of Western moral philosophy, a set of principles that should guide nursing activity. PMID:25590875

  15. Medical Ethics Teaching Programs at the University of California, San Francisco, and the University of Washington.

    ERIC Educational Resources Information Center

    Jonsen, Albert R.

    1989-01-01

    The development of medical ethics education at the University of California, San Francisco, is chronicled and its contributions to bioethics literature are noted. Emphasis is placed on the importance of using medical cases in such instruction. The University of Washington's ethics program and its potential for innovation are then described.…

  16. Medical Ethics Teaching Programs at the University of California, San Francisco, and the University of Washington.

    ERIC Educational Resources Information Center

    Jonsen, Albert R.

    1989-01-01

    The development of medical ethics education at the University of California, San Francisco, is chronicled and its contributions to bioethics literature are noted. Emphasis is placed on the importance of using medical cases in such instruction. The University of Washington's ethics program and its potential for innovation are then described.…

  17. The essential role of medical ethics education in achieving professionalism: the Romanell Report.

    PubMed

    Carrese, Joseph A; Malek, Janet; Watson, Katie; Lehmann, Lisa Soleymani; Green, Michael J; McCullough, Laurence B; Geller, Gail; Braddock, Clarence H; Doukas, David J

    2015-06-01

    This article-the Romanell Report-offers an analysis of the current state of medical ethics education in the United States, focusing in particular on its essential role in cultivating professionalism among medical learners. Education in ethics has become an integral part of medical education and training over the past three decades and has received particular attention in recent years because of the increasing emphasis placed on professional formation by accrediting bodies such as the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Yet, despite the development of standards, milestones, and competencies related to professionalism, there is no consensus about the specific goals of medical ethics education, the essential knowledge and skills expected of learners, the best pedagogical methods and processes for implementation, and optimal strategies for assessment. Moreover, the quality, extent, and focus of medical ethics instruction vary, particularly at the graduate medical education level. Although variation in methods of instruction and assessment may be appropriate, ultimately medical ethics education must address the overarching articulated expectations of the major accrediting organizations. With the aim of aiding medical ethics educators in meeting these expectations, the Romanell Report describes current practices in ethics education and offers guidance in several areas: educational goals and objectives, teaching methods, assessment strategies, and other challenges and opportunities (including course structure and faculty development). The report concludes by proposing an agenda for future research. PMID:25881647

  18. Ethical issues of medical missions: the clinicians' view.

    PubMed

    Ott, Barbara B; Olson, Robert M

    2011-06-01

    Surgery is an important part of health care worldwide. Without access to surgical treatments, morbidity and mortality increase. Access to surgical treatment is a significant problem in global public health because surgical services are not equally distributed in the world. There is a disproportionate scarcity of surgical access in low-income countries. There are many charitable organizations around the world that sponsor surgical missions to under served nations. One such organization is Operation Smile International, a group with which both authors have volunteered. This paper will describe the purpose and processes involved in Operation Smile and identify some of the key ethical issues that arise in short term medical volunteer work highlighting the importance of sustainability. PMID:21598049

  19. Genetic screening; Medical promise amid legal and ethical questions

    SciTech Connect

    Baum, R.M. )

    1989-08-01

    As efforts gear up to map and sequence the human genome, increasing attention is being focused on the ethical, social and legal issues raised by the acquisition and use of genetic information. Several types of genetic screening carried out in a variety of settings hold enormous potential for improving health care. But such screening also poses an array of questions that are only now being addressed. Other applications of humanity's newfound and rapidly growing ability to peer into the genetic makeup of an individual also have serious implications. Use of so-called DNA fingerprinting, for instance, troubles some observers who question the reliability of such analyses carried out on a large scale and who worry about the effects on civil liberties of widespread genetic testing for identification purposes. The author discusses how genetic screening for medical purposes, though, seems to raise a broader array of difficult questions than do other uses of genetic information.

  20. [Hippocrates and Schweitzer - comparison of their concepts of medical ethics].

    PubMed

    Romankow, J

    1999-01-01

    The Greek physician Hippocrates (c. 460-377 BC) is traditionally regarded as the founder of medicine as a scientific discipline and medical ethics. Hippocrates sought to rely on facts, observation and experiment in the diagnosis and treatment of illness. His work Corpus Hippocraticum included also the remarques on the aspects of environmental medicine. Albert Schweitzer (1875-1965), recipient of the 1952 Nobel Peace Prize, attained fame as a theologian and musician (his activity included a modern interpretation of J.S. Bach) before turning to missionary work in Africa. Having trained as a physician in Strasbourg, he founded (1913) a hospital at Lambarene, Gabon, to which he dedicated the rest of his life. Early in his life he felt deep "reverence for life". His philosophy culminated in an universal affirmative ethnics of an active charity. PMID:11625712

  1. The medical theory of Richard Koch I: theory of science and ethics.

    PubMed

    Töpfer, F; Wiesing, U

    2005-01-01

    Richard Koch first made his appearance in the 1920s with works published on the foundations of medicine. These publications describe the character of medicine as an action and the status of medicine within the theory of science. One of his conclusions is that medicine is not a science in the original sense of the word, but a practical discipline. It serves a practical purpose: to heal the sick. All medical knowledge is oriented towards this purpose, which also defines the physician's role. One kind of knowledge is diagnosis, which is strictly understood in relation to therapy, and is at the core of medical thinking. Diagnosis is not the assignment of a term of a species to a patient's disease: this would not do justice to the individuality of a clinical manifestation and would fail to provide a reason for individual therapy. Nevertheless, the terms assigned to diseases, although fictitious, are not useless, but assist in differentiating various phenomena. These conclusions carry ethical consequences. Because the task of helping the sick constitutes medicine, morals not only set ethical limits: medicine originates in a moral decision. If there are no diseases but only individual sick people, disease can not be defined as an abnormality. The individual benefit to the patient must not necessarily be the complete restoration of health. With its object being incalculable, medicine cannot guarantee its own success. Here the physician has to develop principles that allow for the best possible response to the challenges faced in varying situations of conduct. PMID:16215800

  2. Ethical principles and the rationing of health care: a qualitative study in general practice

    PubMed Central

    Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

    2005-01-01

    Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

  3. Universal ethical principles in a diverse universe: a commentary on Monshi and Zieglmayer's case study.

    PubMed

    DuBois, James M

    2004-01-01

    Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles--of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978)--useful in international settings?, and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research? PMID:16625726

  4. Anticholinesterases: Medical applications of neurochemical principles

    SciTech Connect

    Millard, C.B.; Broomfield, C.A.

    1995-12-31

    Cholinesterases form a family of serine esterases that arise in animals from at least two distinct genes. Multiple forms of these enzymes can be precisely localized and regulated by alternative mRNA splicing and by co- or posttranslational modifications. The high catalytic efficiency of the cholinesterases is quelled by certain very selective reversible and irreversible inhibitors. Owing largely to the important role of acetylcholine hydrolysis in neurotransmission, cholinesterase and its inhibitors have been studied extensively in vivo. In parallel, there has emerged an equally impressive enzyme chemistry literature. Cholinesterase inhibitors are used widely as pesticides; in this regard the compounds are beneficial with concomitant health risks. Poisoning by such compounds can result in an acute but usually manageable medical crisis and may damage the ONS and the PNS, as well as cardiac and skeletal muscle tissue. Some inhibitors have been useful for the treatment of glaucoma and myasthenia gravis, and others are in clinical trials as therapy for Alzheimer`s dementia. Concurrently, the most potent inhibitors have been developed as highly toxic chemical warfare agents. We review treatments and sequelae of exposure to selected anticholinesterases, especially organophosphorus compounds and carbamates, as they relate to recent progress in enzyme chemistry.

  5. Transforming educational accountability in medical ethics and humanities education toward professionalism.

    PubMed

    Doukas, David J; Kirch, Darrell G; Brigham, Timothy P; Barzansky, Barbara M; Wear, Stephen; Carrese, Joseph A; Fins, Joseph J; Lederer, Susan E

    2015-06-01

    Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician. PMID:25539516

  6. Bioethics Principles, Informed Consent, and Ethical Care for Special Populations: Curricular Needs Expressed by Men and Women Physicians-in-Training

    PubMed Central

    Roberts, Laura Weiss; M.A., Cynthia; Geppert; Warner, Teddy D.; Green Hammond, Katherine A.; Lamberton, Leandrea Prosen

    2006-01-01

    Objective Physicians-in-training today are learning in an ethical environment that is unprecedented in its complexity. There is a call for new approaches in preparing medical students and residents for the ethical and professional issues they will encounter. The perspectives of physicians-in-training at different levels regarding the level of curricular attention needed for emerging bioethics concepts, practical informed consent considerations, and the care of special populations are unknown. Method The authors performed a hypothesis-driven, confidential survey study to assess perceived needs and preferences among medical students and residents related to medical ethics education at the University of New Mexico School of Medicine. Results A total of 336 physicians-in-training volunteered (62% response rate). Overall, strong interest was expressed for increased curricular attention to the domains of bioethics principles, informed consent, and care of special populations. Women students expressed greater interest generally. For certain domains, clinical students expressed relatively less curricular need and psychiatry and primary care residents expressed relatively greater curricular need. Two of the four hypotheses were supported, a third received partial support, and a fourth was not supported by the findings. Discussion To be valuable and effective, new ethics curricular approaches must be responsive to the current complex ethical environment and attentive to the preferences of medical students and residents of both genders, at different stages of training, with different patient care responsibilities. This hypothesis-driven study provides guidance for the inclusion of novel and important ethics domains in training curricula across medical school and diverse residency programs. PMID:16145189

  7. Towards a community effort to identify ethical principles for research in hydrology

    NASA Astrophysics Data System (ADS)

    Montanari, Alberto

    2010-05-01

    The hydrological community in Europe is growing rapidly in both size and, more importantly, scientific relevance and integrity. The Hydrological Sciences (HS) Division of EGU actively is promoting the above development by identifying research targets, stimulating the involvement of young scientists and managing a scientific open access journal based on a public peer review process. The management of the Division itself and the organisation of the General Assembly are carried out transparently, with the aim to seek an improved involvement of top and young scientists, with a bottom up approach. I believe the HS community is animated by a strong enthusiasm which, however, is not adequately supported by economical funding. In my opinion this is a major problem which HS should consider and discuss. The relevance of the societal and environmental problems dealt with by hydrologists, in a professional way and with exceptional scientific skills, is without doubt and therefore the limited amount of funding is not justified in practice. In my opinion, in order to refine the structure of the HS community, and promote its visibility, we should formally identify HS ethical principles for research in environmental science. The principles should highlight the role of hydrology as well as the ethical and scientific solidity of the HS community. Establishing ethical principles is even more important in view of the transparent approach HS is adopting for reviewing and publishing contributions and in view of the increasing need to transparently prove how public funding for research is administered. Establishing ethical principles for hydrology is not a trivial task. Hydrology is characterised by a relevant uncertainty in data, models and parameters. Hydrology is also relying on a large variety of approaches, ranging from statistical to physically based. The purpose of this poster is to present a collection of ethical principles for scientific research presented by the literature and/or adopted by institutions. The aim is to stimulate a discussion within the HS community in order to finally propose a collection of principles and rules of conduct that can apply to hydrology. I believe that the visibility and the solidity of the HS community will benefit by placing emphasis on the role of ethics.

  8. Comparing Healthcare Systems: Outcomes, Ethical Principles, and Social Values

    PubMed Central

    Kluge, Eike-Henner W.

    2007-01-01

    The question of how healthcare should be structured has been at the forefront of public debate for quite some time. In particular, debate has raged over the acceptability of socialized and rights-oriented approaches to healthcare as opposed to privatized and commodity-oriented approaches. The present discussion looks at the underlying logic of the debate and at the use of outcome measures as a primary determinant. It suggests that outcome measures are of limited use in deciding the issue because they ignore important variables and further suggests that outcome measures are inappropriate tools when comparing distinct healthcare systems because they ignore valuational components that are integral to deciding whether a healthcare system is consistent with a society's principles and values. PMID:18311379

  9. [Universal ethical principles and their application in clinical drug trials].

    PubMed

    Gonorazky, Sergio Eduardo

    2015-03-01

    Since 1931, and especially since the Nuremberg Code of 1947, an increasing number of declarations, regulations, norms, guidelines, laws, resolutions, and rules intended to create conditions for better protection of subjects participating in research studies have been published, although some have meant setbacks in the human rights of vulnerable populations. As such, violations of the dignity of experimental subjects in clinical trials continue. What researchers investigate and how the research is done, the quality and transparency of the data, and the analysis and the publication of results (of both raw and processed data) respond to the financial interests of the pharmaceutical companies, coming into permanent tension with bioethical principles and the needs of society. The active participation of civil society is necessary to make it so that pharmaceutical research, results and applications subordinate economic benefits to the protection of human rights. PMID:25853830

  10. An obstructed death and medical ethics -- a case conference revisited: commentary 2.

    PubMed Central

    Higgs, Roger

    1990-01-01

    The dilemma of whether or not a doctor should tell a patient dying of cancer the truth remains a difficult one, as the disagreement between the two previous writers shows. One favours giving priority to patient autonomy, the other feels the doctor's duty of beneficence should be the overriding principle governing such decisions. To this contributor it seems both approaches have something to offer. By being sensitive to what and how much the patient wishes to know and by learning from the insights provided by the study of medical ethics, doctors can learn how to make better moral decisions in this and in other areas. Both lying and truth-telling carry risks of harm to the patient. Learning to work with and balance these risks is part of clinical practice. So is minimising risks by clear thinking. PMID:11642781

  11. Perceptions and practices of medical practitioners towards ethics in medical practice - a study from coastal South India.

    PubMed

    Unnikrishnan, B; Kanchan, Tanuj; Kulkarni, Vaman; Kumar, Nithin; Papanna, Mohan Kumar; Rekha, T; Mithra, Prasanna

    2014-02-01

    Ethics is the application of values and moral rules to human activities. Medical practitioners are expected to not only have the skills and knowledge relevant to their field but also with the ethical and legal expectations that arise out of the standard practices. The present research was conducted with an aim to study the perceptions and practices of medical practitioners towards healthcare ethics in Indian scenario and to strengthen the evidence in the field of ethics training. A cross-sectional study was carried out in three associate hospitals of a Medical College in Southern India. Medical practitioners included in the study were administered a pre-tested, semi-structured questionnaire. Data was collected based on their responses on a 5 point Likert scale and analyzed using SPSS version 11.5. The majority of the participants mentioned that their perceptions of ethics in medical practice were based on information obtained during their undergraduate training, followed by experience at work. The medical practitioners had a positive perception on issues relating to consent in medical practice. However, the same degree of perception was not observed for issues related to confidentiality and their dealing with patients during emergency conditions. The majority of the medical practitioners agreed that ethical conduct is important to avoid legal and disciplinary actions. Among the medical practitioners, the responses of specialists and non-specialists were mostly similar with major differences of opinion for a few issues. A highest level of knowledge, awareness and understanding of ethics are expected in medical practice as it is the foundation of sound healthcare delivery system. PMID:24485422

  12. The first ten principles for the ethical administration of nursing services.

    PubMed

    Curtin, L L

    2000-01-01

    At the dawn of the 20th century, postmodern academics stressed the cultural differences among human beings. Philosophers predicated differing value systems based on these cultural differences, and conflicts have arisen among those who hold distinctly different religious traditions. Many people believe there can be no universal system to explain reality and thus form the basis for norms in human behavior. However, at the close of the 20th century scientists and philosophers had come full circle: physics quite literally became metaphysics, and ethical systems made sense. Rush Kidder interviewed two dozen "men and women of good conscience" from around the world and asked them if there is a single set of values that wise people use to make decisions. They answered with a resounding YES! Thus, in addition to the customary principles of beneficence, nonmalfeasance, honesty, and so forth, the author proposes a set of ethical principles based on those universal values, adapted to fit nursing administrators' dual responsibilities. Ethical decision making and behavior, the author contends, help to reconcile perspectives and interests and to keep values and mission uppermost in one's mind. In the process, ethical behavior establishes long-term relations of trust and cooperation, which in turn promote consistency and stability in an unstable world. PMID:18188901

  13. The challenge of promoting professionalism through medical ethics and humanities education.

    PubMed

    Doukas, David J; McCullough, Laurence B; Wear, Stephen; Lehmann, Lisa S; Nixon, Lois LaCivita; Carrese, Joseph A; Shapiro, Johanna F; Green, Michael J; Kirch, Darrell G

    2013-11-01

    Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome. PMID:24072126

  14. How “moral” are the principles of biomedical ethics? – a cross-domain evaluation of the common morality hypothesis

    PubMed Central

    2014-01-01

    Background The principles of biomedical ethics – autonomy, non-maleficence, beneficence, and justice – are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. Methods We evaluated the perceived degree of “morality” of 14 values relevant to medicine (n1 = 317, students and professionals) and 14 values relevant to business & finance (n2 = 247, students and professionals). Ratings were made along four dimensions intended to characterize different aspects of morality. Results We found that compared to other values, the principles-related values received lower ratings across several dimensions that characterize morality. By interpreting our finding using a clustering and a network analysis approach, we suggest that the principles can be understood as “bridge values” that are connected both to moral and non-moral aspects of ethical dilemmas in medicine. We also found that the social domain (medicine vs. business & finance) influences the degree of perceived morality of values. Conclusions Our results are in conflict with the common morality hypothesis of Beauchamp and Childress, which would imply domain-independent high morality ratings of the principles. Our findings support the suggestions by other scholars that the principles of biomedical ethics serve primarily as instruments in deliberated justifications, but lack grounding in a universal “common morality”. We propose that the specific manner in which the principles are taught and discussed in medicine – namely by referring to conflicts requiring a balancing of principles – may partly explain why the degree of perceived “morality” of the principles is lower compared to other moral values. PMID:24938295

  15. Comparing the Principle-Based SBH Maieutic Method to Traditional Case Study Methods of Teaching Media Ethics

    ERIC Educational Resources Information Center

    Grant, Thomas A.

    2012-01-01

    This quasi-experimental study at a Northwest university compared two methods of teaching media ethics, a class taught with the principle-based SBH Maieutic Method (n = 25) and a class taught with a traditional case study method (n = 27), with a control group (n = 21) that received no ethics training. Following a 16-week intervention, a one-way…

  16. Comparing the Principle-Based SBH Maieutic Method to Traditional Case Study Methods of Teaching Media Ethics

    ERIC Educational Resources Information Center

    Grant, Thomas A.

    2012-01-01

    This quasi-experimental study at a Northwest university compared two methods of teaching media ethics, a class taught with the principle-based SBH Maieutic Method (n = 25) and a class taught with a traditional case study method (n = 27), with a control group (n = 21) that received no ethics training. Following a 16-week intervention, a one-way…

  17. 77 FR 2556 - Ethical and Regulatory Challenges in the Development of Pediatric Medical Countermeasures; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... HUMAN SERVICES Food and Drug Administration Ethical and Regulatory Challenges in the Development of...) leveraging new technologies to develop pediatric medical countermeasures; and (4) risk communication related... are complex ] and need to be better understood by ethicists, researchers, policymakers, and...

  18. [Effects of the Internet on the dissemination of medical information: some thoughts on applied ethics].

    PubMed

    Lucas, Jacques

    2009-10-01

    Learned and professional societies as well as health authorities must attempt to provide free access to their databases for physicians, by a simple repertory of key words and, if necessary, by portals. Although information available for physicians may not be intended to be secret, it often requires some professional training to be interpreted appropriately. The principles of the Code of Medical Ethics, as transcribed in the Public Health Code, apply to all forms and media of information and communication. In public spaces, readers must be guaranteed that information written by physicians corresponds to the state of the art, that it is not advertising or self-promotion or commercial, that it was developed by a process ensuring quality, and that it distinguishes clearly between a popularized description of scientific data and what remains uncertain because research is on-going. The public should be informed about the source of the information they see, the editorial quality of the site, and any potential financial dependence or conflicts of interest. According to the medical association, prudence is recommended for physicians who moderate chat-rooms and discussion lists. List moderation, like any other type of medical activity, must not be improvised; it requires prudence, thought, and training. PMID:19767173

  19. Bioethical conflicts between Muslim patients and German physicians and the principles of biomedical ethics.

    PubMed

    Ilkilic, Ilhan

    2002-01-01

    In the age of globalisation, more and more people who are members of different religions and cultures live in the same society. This situation tends to create many conflicts in different areas of life and not least in the health care system, a fact which raises a number of bioethical issues. The cultural and religious differences between patient and physician can be a cause of bioethical conflicts and therefore represent a challenge for biomedical ethics. The confrontation between Turkish Muslin patients and the German health care system is a convenient example of this situation. The Muslim Turks came to Germany 40 years ago as industrial workers. Their value system had been shaped by traditional and Islamic parameters in Turkey. With this value system, they now found themselves in the German modern health care system. In many fields of modern medicine there are areas of potential conflict of values, where a Muslin patient will argue differently from a secular or Christian person. In an ethical conflict between two individuals who are members of different cultures, it is necessary to make sure that the ethical concept which is to be used for resolving the problem is relevant. In this particular case, both the Islamic legal responses (fatwa) and the classical theories of biomedical ethics are often insufficient. This paper tries to give a brief outline of these bioethical conflicts and discuss these conflicts with regard to the principle of respect for autonomy in the concept of "principilism," as introduced by T.L. Beauchamp and J.F. Childress. The central question is whether this bioethical concept is able to analyse and to help solve the kinds of ethical conflicts which involve transcultural dimensions. This question is discussed with some consideration of the ongoing debate about universalism versus relativism in biomedical ethics. PMID:12184605

  20. Medical ethics' appropriation of moral philosophy: the case of the sympathetic and the unsympathetic physician.

    PubMed

    Baker, Robert; McCullough, Laurence

    2007-03-01

    Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. PMID:17849660

  1. The Positive Role of Professionalism and Ethics Training in Medical Education: A Comparison of Medical Student and Resident Perspectives

    ERIC Educational Resources Information Center

    Roberts, Laura Weiss; Hammond, Katherine A. Green; Geppert, Cynthia M. A.; Warner, Teddy D.

    2004-01-01

    Objective: To assess the perspectives and preferences of medical students and residents regarding professionalism and ethics education. Methods: A new written survey with 124 items (scale: "strongly disagree" = 1, "strongly agree" = 9) was sent to all medical students (n = 308) and PGY 1-3 residents (n = 233) at one academic center. Results: Of…

  2. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    PubMed Central

    2013-01-01

    Background Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. Results According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. Conclusions The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry. PMID:24314027

  3. Understanding and applying the principles of contemporary medical professionalism: illustration of a suggested approach, part 2.

    PubMed

    Becker, Gary J

    2015-01-01

    In recent years, formal professionalism education, training, and assessment have been introduced to medical schools and accredited residency training programs. Current constructs of medical professionalism characterize it as a multidimensional competency rather than a trait. Medical professionalism is a belief system for organizing and delivering care, in which group members (medical professionals) promise patients and the public that they will self-regulate (ie, ensure that medical professionals live up to standards of competence and ethical values). Physicians who are good professionals have lapses in professionalism. Responses to professional lapses should focus on remediation. Failure of groups of professionals to enforce the standards and values can convey to patients and the public a lack of trustworthiness and thereby undermine the foundation of professionalism, the social contract. The Physician Charter sets forth the 3 fundamental principles and 10 commitments that offer guidance in some of the most challenging situations. One example is illustrated herein and is continued from Part 1 of this two-part series. PMID:25444064

  4. Ethical issues in Chinese aesthetic surgery.

    PubMed

    Li, Guang-Shuai; Dong, Ming-Min; Liu, Lin-Bo; Hu, Xiao-Ying

    2014-10-01

    Guided by the medical ethics principles of "four principles plus scope," Chinese aesthetic medical practitioners have proposed some extremely valuable ethical principles combined with the construction of aesthetic medicine and the requirements of clinical practice such as the principle of general nonmaleficence, the principle of local minimal invasiveness, the principle of informed consent, and the principle of respect and confidentiality. Chinese aesthetic surgical ethics provide valuable guidance for the practice of aesthetic medicine. Adherence to the ethics of Chinese aesthetic surgery provides an essential guide for the practice of aesthetic medicine in China. These principles protect both the medical practitioner and the patient, helping them to avoid unnecessary risks and disputes and ultimately promoting the sustainable development of aesthetic medicine. PMID:25028113

  5. A case study from the perspective of medical ethics: refusal of treatment in an ambulance.

    PubMed

    Erbay, Hasan; Alan, Sultan; Kad?o?lu, Selim

    2010-11-01

    This paper will examine a sample case encountered by ambulance staff in the context of the basic principles of medical ethics. An accident takes place on an intercity highway. Ambulance staff pick up the injured driver and medical intervention is initiated. The driver suffers from a severe stomach ache, which is also affecting his back. Evaluating the patient, the ambulance doctor suspects that he might be experiencing internal bleeding. For this reason, venous access, in the doctor's opinion, should be achieved and the patient should be quickly started on an intravenous serum. The patient, however, who has so far kept his silence, objects to the administration of the serum. The day this is taking place is within the month of Ramadan and the patient is fasting. The patient states that he is fasting and that his fast will be broken and his religious practice disrupted in the event that the serum is administered. The ambulance doctor informs him that his condition is life-threatening and that the serum must be administered immediately. The patient now takes a more vehement stand. 'If I am to die, I want to die while I am fasting. Today is Friday and I have always wanted to die on such a holy day,' he says. The ambulance physician has little time to decide. How should the patient be treated? Which type of behaviour will create the least erosion of his values? PMID:20663758

  6. The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research.

    PubMed

    2014-01-01

    On July 12, 1974, the National Research Act (Pub. L. 93-348) was signed into law, thereby creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. One of the charges to the Commission was to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and to develop guidelines which should be followed to assure that such research is conducted in accordance with those principles. In carrying out the above, the Commission was directed to consider: (a) the boundaries between biomedical and behavioral research and the accepted and routine practice of medicine, (b) the role of assessment of risk-benefit criteria in the determination of the appropriateness of research involving human subjects, (c) appropriate guidelines for the selection of human subjects for participation in such research and (d) the nature and definition of informed consent in various research settings. The Belmont Report attempts to summarize the basic ethical principles identified by the Commission in the course of its deliberations. It is the outgrowth of an intensive four-day period of discussions that were held in February 1976 at the Smithsonian Institution's Belmont Conference Center supplemented by the monthly deliberations of the Commission that were held over a period of nearly four years. It is a statement of basic ethical principles and guidelines that should assist in resolving the ethical problems that surround the conduct of research with human subjects. By publishing the Report in the Federal Register, and providing reprints upon request, the Secretary intends that it may be made readily available to scientists, members of Institutional Review Boards, and Federal employees. The two-volume Appendix, containing the lengthy reports of experts and specialists who assisted the Commission in fulfilling this part of its charge, is available as DHEW Publication No. (OS) 78-0013 and No. (OS) 78-0014, for sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Unlike most other reports of the Commission, the Belmont Report does not make specific recommendations for administrative action by the Secretary of Health, Education, and Welfare. Rather, the Commission recommended that the Belmont Report be adopted in its entirety, as a statement of the Department's policy. The Department requests public comment on this recommendation. PMID:25951677

  7. Not fit for purpose: the ethical guidelines of the Indian Council of Medical Research.

    PubMed

    Satalkar, Priya; Shaw, David

    2015-04-01

    In 2006, the Indian Council of Medical Research (ICMR) published its 'Ethical guidelines for Biomedical Research on human participants'. The intention was to translate international ethical standards into locally and culturally appropriate norms and values to help biomedical researchers in India to conduct ethical research and thereby safeguard the interest of human subjects. Unfortunately, it is apparent that the guideline is not fit for purpose. In addition to problems with the structure and clarity of the guidelines, there are several serious omissions and contradictions in the recommendations. In this paper, we take a close look at the two key chapters and highlight some of the striking flaws in this important document. We conclude that ethics committees and national authorities should not lose sight of international ethical standards while incorporating local reality and cultural and social values, as focusing too much on the local context could compromise the safety of human subjects in biomedical research, particularly in India. PMID:25897444

  8. NAPPH (National Association of Private Psychiatric Hospitals) statement of principles of psychiatric hospital practice ethics.

    PubMed

    1989-01-01

    A competitive and dynamic healthcare environment requires that psychiatric hospital administrators and physicians continually monitor their hospital's ability to deliver quality services to their patients. To ensure that hospitals stand for and abide by psychiatric hospital practice ethics, the National Association of Private Psychiatric Hospitals (NAPPH) Board of Trustees has formally approved and distributed to the industry a "Statement of Principles of Psychiatric Hospital Practice Ethics." Adopted at the June 22, 1989, Board meeting, the guidelines not only summarize views long held in the industry, but are a condition of NAPPH membership. Nine critical areas are identified in the NAPPH statement: admissions, advertising, marketing and referral development, resource allocation and appropriateness of care, treatment rendered, patients' rights, family rights and involvement, competition, and financial resources. Central to ethical hospital practice is a moral responsibility--shared among administrators, trustees, physicians and staff--to ensure access to care, quality of care, and fair treatment of patients. NAPPH represents more than 300 private psychiatric hospitals throughout the United States, and the NAPPH mission includes the promotion of high-quality care and treatment, efficient hospital operation, and advocacy for the patients served by its member hospitals. Each NAPPH hospital actively supports the appropriate, safe, and compassionate treatment of the mentally ill. PMID:10296960

  9. Biopiracy and the ethics of medical heritage: the case of India's traditional knowledge digital library'.

    PubMed

    Kidd, Ian James

    2012-09-01

    Medical humanities have a central role to play in combating biopiracy. Medical humanities scholars can articulate and communicate the complex structures of meaning and significance which human beings have invested in their ways of conceiving health and sickness. Such awareness of the moral significance of medical heritage is necessary to ongoing legal, political, and ethical debates regarding the status and protection of medical heritage. I use the Indian Traditional Knowledge Digital Library as a case study of the role of medical humanities in challenging biopiracy by deepening our sense of the moral value of medical heritage. PMID:22610726

  10. [Two years' experience teaching medical ethics in a hospital clinic course].

    PubMed

    Mantz, J M; Bastian, B

    1991-11-01

    Ethics problems arise from conflict of values: a physician has to take charge of his patients, but advances of sciences and technics make such conflicts more and more frequent. Their solution cannot be left to a mere improvization. Medical ethics have to be taught. In Strasbourg, we have elected to teach compulsory medical ethics in the course of compulsory hospital training, for five mornings running, to groups of ten fifth-year medical students, the place being different each day. Fifteen departments including five specialties, internal medicine, intensive care, pediatrics, gynecology-obstetrics, geriatrics, are involved in this experience. The training takes place near the patient bed in the presence of a medical teacher. Communication and multi-disciplinarity are the characteristics. The teaching is done with the purpose of bringing about reflection in the students, of proposing methods for the discovering and the approach of ethics problems, of leading the students up to the enlightenment of their own scale of evaluation. A few previous lectures about history of ethics through different philosophical systems, about social, economical and cultural implications, are given for basic formation of the students. This teaching experience interests students and teachers greatly. The first ones have the opportunity to perceive a new dimension of medical responsibility, the second ones appreciate this form of recovered fellowship. PMID:1809494

  11. Psychoanalysis and analytic psychotherapy in the NHS--a problem for medical ethics.

    PubMed Central

    Wilkinson, G

    1986-01-01

    I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for. PMID:3735363

  12. Seeing is believing: good graphic design principles for medical research.

    PubMed

    Duke, Susan P; Bancken, Fabrice; Crowe, Brenda; Soukup, Mat; Botsis, Taxiarchis; Forshee, Richard

    2015-09-30

    Have you noticed when you browse a book, journal, study report, or product label how your eye is drawn to figures more than to words and tables? Statistical graphs are powerful ways to transparently and succinctly communicate the key points of medical research. Furthermore, the graphic design itself adds to the clarity of the messages in the data. The goal of this paper is to provide a mechanism for selecting the appropriate graph to thoughtfully construct quality deliverables using good graphic design principles. Examples are motivated by the efforts of a Safety Graphics Working Group that consisted of scientists from the pharmaceutical industry, Food and Drug Administration, and academic institutions. PMID:26112209

  13. What future for ethical medical practice in the new National Health Service?

    PubMed Central

    Persaud, R D

    1991-01-01

    The British Government is implementing some major alterations to the way health services in Great Britain are organised. As well as the introduction of competition between health care providers, their financial interests are to be linked to their output, in efforts to use market forces to increase efficiency and cut costs. This paper looks at the possible impact of these changes of health care organisation on ethical medical practice. This is investigated with particular reference to the country whose health service has embraced most closely these elements of the market--the United States of America. The question to be answered is whether high standards of ethical care are ensured by factors somehow intrinsic to the medical profession, and are therefore immune to changes in the economics of health care. This assumption is shown to be questionable in light of what is known about the determinants of ethical medical practice. PMID:2033624

  14. Ethics of care in medical tourism: Informal caregivers' narratives of responsibility, vulnerability and mutuality.

    PubMed

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2015-09-01

    This study examines the experiences of informal caregivers in medical tourism through an ethics of care lens. We conducted semi-structured interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery, asking questions that dealt with their experiences prior to, during and after travel. Thematic analysis revealed three themes central to an ethics of care: responsibility, vulnerability and mutuality. Ethics of care theorists have highlighted how care has been historically devalued. We posit that medical tourism reproduces dominant narratives about care in a novel care landscape. Informal care goes unaccounted for by the industry, as it occurs in largely private spaces at a geographic distance from the home countries of medical tourists. PMID:26313855

  15. Ethical Expert Systems

    PubMed Central

    Victoroff, Michael S.

    1985-01-01

    The title is a double entendre. The discussion approaches expert systems from two directions: “What ethical hazards are created by expert systems in medicine?” and “Would it be ethical to design an expert system for solving problems in bioethics?” Computers present new ethical problems to society, some of which are unprecedented. These can be categorized under several rubrics. The paper describes a rudimentary scheme for understanding ethical issues raised by computers, in general, and medical expert systems, in particular. It focuses on bioethical implications of AI in medicine; explores norms, assumptions and taboos; and highlights certain ethical pitfalls. Principles are elucidated, for building ethically sound systems. Finally, a proposal is discussed, for the design of an expert system for moral problem solving, and the ethical implications of this notion are analyzed.

  16. Reuse Of Pacemakers In Ghana And Nigeria: Medical, Legal, Cultural And Ethical Perspectives.

    PubMed

    Ochasi, Aloysius; Clark, Peter

    2015-12-01

    According to the World Health Organization (WHO) cardiovascular disease (CVD) is the leading cause of death globally. Over 80% of CVD deaths take place in low- and middle-income countries (LMICs). It is estimated that 1 million to 2 million people worldwide die each year due to lack of access to an implantable cardiac defibrillator (ICD) or a pacemaker. Despite the medical, legal, cultural and ethical controversies surrounding the pacemaker reutilization, studies done so far on the reuse of postmortem pacemakers show it to be safe and effective with an infection rate of 1.97% and device malfunction rate of 0.68%. Pacemaker reutilization can be effectively and safely done and does not pose significant additional risk to the recipient. Heart patients with reused pacemakers have an improved quality of life compared to those without pacemakers. The thesis of this paper is that pacemaker reutilization is a life-saving initiative in LMICs of Nigeria and Ghana. It is cost effective; consistent with the principles of beneficence, nonmaleficence, and justice with a commitment to stewardship of resources and the Common Good. Used pacemakers with adequate battery life can be properly sterilized for use by patients in LMICs who cannot afford the cost of a new pacemaker. PMID:24720369

  17. Helping doctors become better doctors: Mary Lobjoit--an unsung heroine of medical ethics in the UK.

    PubMed

    Brazier, Margaret R; Gillon, Raanan; Harris, John

    2012-06-01

    Medical Ethics has many unsung heros and heroines. Here we celebrate one of these and on telling part of her story hope to place modern medical ethics and bioethics in the UK more centrally within its historical and human contex. PMID:22518049

  18. Helping doctors become better doctors: Mary Lobjoit—an unsung heroine of medical ethics in the UK

    PubMed Central

    Brazier, Margaret R; Gillon, Raanan

    2012-01-01

    Medical Ethics has many unsung heros and heroines. Here we celebrate one of these and on telling part of her story hope to place modern medical ethics and bioethics in the UK more centrally within its historical and human contex. PMID:22518049

  19. Family medicine and medical ethics--a natural and necessary union.

    PubMed

    Dickman, R L

    1980-04-01

    Since many ethical dilemmas in the practice of medicine involve cases associated with tertiary care, primary care providers may feel removed from these kinds of problems. Family medicine, committed to an intellectual synergism with a variety of non-biomedical disciplines as well as being a "specialty in breadth" should develop a strong bond with medical ethics. Because of their ongoing relationships with patients and subsequent knowledge of their value systems, family physicians can provide leadership in guiding ethical decision making in intensive care settings. In addition, since a significant number of ethical dilemmas in medicine involve common problems, family physicians may be more sensitive to and feel more comfortable with this aspect of medical practice. Some family practice residency programs have begun to provide educational experiences in medical ethics for their trainees. Although the evaluation methodology for this aspect of training is not fully developed, it seems clear that residency programs should give additional attention to these areas in planning their curricula. PMID:7365436

  20. Shared Principles of Ethics for Infant and Young Child Nutrition in the Developing World

    PubMed Central

    2010-01-01

    Background The defining event in the area of infant feeding is the aggressive marketing of infant formula in the developing world by transnational companies in the 1970s. This practice shattered the trust of the global health community in the private sector, culminated in a global boycott of Nestle products and has extended to distrust of all commercial efforts to improve infant and young child nutrition. The lack of trust is a key barrier along the critical path to optimal infant and young child nutrition in the developing world. Discussion To begin to bridge this gap in trust, we developed a set of shared principles based on the following ideals: Integrity; Solidarity; Justice; Equality; Partnership, cooperation, coordination, and communication; Responsible Activity; Sustainability; Transparency; Private enterprise and scale-up; and Fair trading and consumer choice. We hope these principles can serve as a platform on which various parties in the in the infant and young child nutrition arena, can begin a process of authentic trust-building that will ultimately result in coordinated efforts amongst parties. Summary A set of shared principles of ethics for infant and young child nutrition in the developing world could catalyze the scale-up of low cost, high quality, complementary foods for infants and young children, and eventually contribute to the eradication of infant and child malnutrition in the developing world. PMID:20529339

  1. Religious morality (and secular humanism) in Western civilization as precursors to medical ethics: A historic perspective

    PubMed Central

    Faria, Miguel A.

    2015-01-01

    In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention) of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience) journalism. Should independent medical journals abstain from discussing certain issues, or should only the major medical journals — i.e., the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA) or Lancet — be heard, speaking with one “consensual,” authoritative voice? This issue is particularly important in controversial topics impacting medical politics — e.g., public health policy, socio-economics, bioethics, and the so-called redistributive justice in health care. Should all sides be heard when those controversial topics are discussed or only a consensual (monolithic) side? This historical review article discusses those issues and opts for freedom in medical and surgical practice as well as freedom in medical journalism, particularly in opinion pieces such as editorials, commentaries, or letters to the editor, as long as they relate to medicine and, in our special case, to neuroscience and neurosurgery. After answering those questions, and in response to a critical letter to the editor, this review article then expounds comprehensively on the historical and philosophical origins of ethics and religious morality. Necessarily, we discuss the Graeco-Roman legacy and the Judeo-Christian inheritance in the development of ethics and religious morality in Western civilization and their impact on moral conduct in general and on medical and neuroscience ethics in particular. PMID:26110085

  2. Hunger strikers: ethical and legal dimensions of medical complicity in torture at Guantanamo Bay.

    PubMed

    Dougherty, Sarah M; Leaning, Jennifer; Greenough, P Gregg; Burkle, Frederick M

    2013-12-01

    Physicians and other licensed health professionals are involved in force-feeding prisoners on hunger strike at the US Naval Base at Guantanamo Bay (GTMO), Cuba, the detention center established to hold individuals captured and suspected of being terrorists in the wake of September 11, 2001. The force-feeding of competent hunger strikers violates medical ethics and constitutes medical complicity in torture. Given the failure of civilian and military law to end the practice, the medical profession must exert policy and regulatory pressure to bring the policy and operations of the US Department of Defense into compliance with established ethical standards. Physicians, other health professionals, and organized medicine must appeal to civilian state oversight bodies and federal regulators of medical science to revoke the licenses of health professionals who have committed prisoner abuses at GTMO. PMID:24073786

  3. Impact of managed care on the development of new medical technology: ethical concerns

    NASA Astrophysics Data System (ADS)

    Saha, Pamela; Saha, Subrata

    1995-10-01

    During the last three decades, development of new medical technology has been largely responsible for the spectacular advances in the diagnosis and treatment of many human diseases. This has contributed to improved medical care of our population. However, concerns have been raised that in today's managed care environment of health care, introduction of new medical technology will be difficult. Cost-sensitive health care providers should consider various ethical issues involved before demanding that only those technologies that save money and show highly positive cost benefit ratio will be reimbursed. The impact of such considerations on the innovations of new medical devices and their developments is discussed.

  4. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    ERIC Educational Resources Information Center

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

  5. Medication-Related Practice Roles: An Ethical and Legal Primer for School Psychologists

    ERIC Educational Resources Information Center

    Shahidullah, Jeffrey D.

    2014-01-01

    Given the prevalence of school-age children and adolescents who are prescribed with and are taking psychotropic medications, a critical issue that school psychologists may likely encounter in contemporary practice is providing both quality and continuity of care to these students in the context of relevant legal and ethical parameters. With a…

  6. Relevance of the Rationalist-Intuitionist Debate for Ethics and Professionalism in Medical Education

    ERIC Educational Resources Information Center

    Leffel, G. Michael; Mueller, Ross A. Oakes; Curlin, Farr A.; Yoon, John D.

    2015-01-01

    Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no…

  7. [Medicine, physicians and medical ethics in Jewish tradition through the ages].

    PubMed

    Gesundheit, Benjamin; Zlotnick, Eitan; Steinberg, Avraham

    2014-08-01

    Medicine has always had a place of honor in the Jewish heritage. Since Biblical times, the sources of Judaism have valued the physician's activities and seen them as a partnership with God's deeds. Later, in the times of the Mishna and the Talmud, a model of scholars evolved who were not only learned sages but also had extensive medical and scientific knowledge. Their dealings with various issues in medical ethics were the basis for deliberation on questions that appeared throughout history on the advancement of medical science. The various sources from this period show the sages' sensitivity regarding the subject of human life, saving lives and the importance of the availability of medicine for all segments of the population. During the years following the completion of the Talmud, the medical profession was common among the Jews and they excelled in this field. Jewish doctors left behind a Legacy of values in medicine. Hebrew was considered a significant Language in the medical field and was cited in various medical texts such as in the book written by Vesalius, the "father" of modern anatomy. The rapid progress of medicine poses new challenges in bioethics. There is a need for physicians with extensive medical knowledge along with an understanding of ethical issues in order to offer solutions to new situations. Knowledge of the Jewish literature throughout the ages on a variety of subjects and the essential values which are their foundation can contribute to the modern discussion on biomedical questions. This is even more important in Israeli society where many of the laws are formed based on Jewish values. Engagement with Jewish medical ethics can help in educating physicians to have the ability to contribute to public debate and legislation in a way that would balance between the values and needs which an ethical issue raises. PMID:25286644

  8. Medical management of patients after bariatric surgery: Principles and guidelines

    PubMed Central

    Elrazek, Abd Elrazek Mohammad Ali Abd; Elbanna, Abduh Elsayed Mohamed; Bilasy, Shymaa E

    2014-01-01

    Obesity is a major and growing health care concern. Large epidemiologic studies that evaluated the relationship between obesity and mortality, observed that a higher body-mass index (BMI) is associated with increased rate of death from several causes, among them cardiovascular disease; which is particularly true for those with morbid obesity. Being overweight was also associated with decreased survival in several studies. Unfortunately, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. All obese patients (BMI ≥ 30 kg/m2) should receive counseling on diet, lifestyle, exercise and goals for weight management. Individuals with BMI ≥ 40 kg/m2 and those with BMI > 35 kg/m2 with obesity-related comorbidities; who failed diet, exercise, and drug therapy, should be considered for bariatric surgery. In current review article, we will shed light on important medical principles that each surgeon/gastroenterologist needs to know about bariatric surgical procedure, with special concern to the early post operative period. Additionally, we will explain the common complications that usually follow bariatric surgery and elucidate medical guidelines in their management. For the first 24 h after the bariatric surgery, the postoperative priorities include pain management, leakage, nausea and vomiting, intravenous fluid management, pulmonary hygiene, and ambulation. Patients maintain a low calorie liquid diet for the first few postoperative days that is gradually changed to soft solid food diet within two or three weeks following the bariatric surgery. Later, patients should be monitored for postoperative complications. Hypertension, diabetes, dumping syndrome, gastrointestinal and psychosomatic disorders are among the most important medical conditions discussed in this review. PMID:25429323

  9. Human guinea pigs and the ethics of experimentation: the BMJ's correspondent at the Nuremberg medical trial.

    PubMed Central

    Weindling, P.

    1996-01-01

    Though the Nuremberg medical trial was a United States military tribunal, British forensic pathologists supplied extensive evidence for the trial. The BMJ had a correspondent at the trial, and he endorsed a utilitarian legitimation of clinical experiments, justifying the medical research carried out under Nazism as of long term scientific benefit despite the human costs. The British supported an international medical commission to evaluate the ethics and scientific quality of German research. Medical opinions differed over whether German medical atrocities should be given publicity or treated in confidence. The BMJ's correspondent warned against medical researchers being taken over by a totalitarian state, and these arguments were used to oppose the NHS and any state control over medical research. Images Fig 1 PMID:8973237

  10. Perceiving Sympathetically: Moral Perception, Embodiment, and Medical Ethics.

    PubMed

    Wisnewski, J Jeremy

    2015-12-01

    In recent literature on moral perception, much attention has been paid to questions about the relationship between metaethical commitments and moral experience. Far less attention has been paid to the nature of moral perception, its context-sensitivity, and the role it might play in carrying out everyday tasks with decency and care. I would like to reflect on just these features of moral perception in the context of healthcare. I will argue that healthcare providers do in fact have at least an imperfect duty (in Kant's sense) to develop their capacities to perceive with sympathy. I will further suggest, for some familiar reasons, that this development is not best accomplished through the model of adherence to 'ethics codes.' PMID:26164290

  11. Voluntary and involuntary sterilization: medical, ethical, legal and religious aspects.

    PubMed

    Fasouliotis, S J; Schenker, J G

    1999-08-01

    Surgical voluntary sterilization has become one of the most widely used methods of contraception, with vasectomy and tubal sterilization being the most commonly employed techniques, associated with a low failure, morbidity, mortality, and long-term sequelae rate. As sterilization is related with the elimination of the possibility for procreation, a number of ethical, legal and religious issues have arisen, leading often to personal misjudgements, legal disputes, and failures in applying family planning. Involuntary sterilization is currently not practiced, except in cases of severely mentally retarded people, who are unable to appreciate the consequences of their acts or care for their children and who may have a high likelihood of propagating hereditary disease. PMID:10534935

  12. Pedagogy and Purpose: Moral Imagination and the Teaching of Medical Ethics.

    PubMed

    Hart, Curtis W

    2016-04-01

    This essay is an exploration of the development of moral imagination as an important outcome in the teaching of medial ethics. It is contextualized within the growth of professionalism and pays attention to the formation of character of physicians in their formal training and in the first phase of their careers. Issues around formation as it is understood historically in the vocation of the clergy are also considered. Finally, there is discussion of the place rites of passage as they figure in the lives of those who teach medical ethics. PMID:26519262

  13. The road being paved to neuroethics: A path leading to bioethics or to neuroscience medical ethics?

    PubMed Central

    Faria, Miguel A.

    2014-01-01

    In 2013, U.S. President Barack Obama decreed the creation of the Presidential Commission for the Study of Bioethical Issues, as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. In the wake of the work of this Commission, the purpose, goals, possible shortcomings, and even dangers are discussed, and the possible impact it may have upon neuroscience ethics (Neuroethics) both in clinical practice as well as scientific research. Concerns were expressed that government involvement in bioethics may have unforeseen and possibly dangerous repercussions to neuroscience in particular and to medicine in general. The author emphasizes that the lessons of history chronicle that wherever governments have sought to alter medical ethics and control medical care, the results have frequently been perverse and disastrous, as in the examples of the communist Soviet Union and National Socialist (Nazi) Germany. The Soviet psychiatrists’ and the Nazi doctors’ dark descent into ghastly experimentation and brutality was a product of convoluted ethics and physicians willingly cooperating with authoritarianism citing utilitarianism in the pursuit of the ‘collective’ or ‘greater good.’ Thus in the 20th century, as governments infringed on the medical profession, even the Liberal Democracies have not been immune to the corruption of ethics in science and medicine. PMID:25324975

  14. The road being paved to neuroethics: A path leading to bioethics or to neuroscience medical ethics?

    PubMed

    Faria, Miguel A

    2014-01-01

    In 2013, U.S. President Barack Obama decreed the creation of the Presidential Commission for the Study of Bioethical Issues, as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. In the wake of the work of this Commission, the purpose, goals, possible shortcomings, and even dangers are discussed, and the possible impact it may have upon neuroscience ethics (Neuroethics) both in clinical practice as well as scientific research. Concerns were expressed that government involvement in bioethics may have unforeseen and possibly dangerous repercussions to neuroscience in particular and to medicine in general. The author emphasizes that the lessons of history chronicle that wherever governments have sought to alter medical ethics and control medical care, the results have frequently been perverse and disastrous, as in the examples of the communist Soviet Union and National Socialist (Nazi) Germany. The Soviet psychiatrists' and the Nazi doctors' dark descent into ghastly experimentation and brutality was a product of convoluted ethics and physicians willingly cooperating with authoritarianism citing utilitarianism in the pursuit of the 'collective' or 'greater good.' Thus in the 20(th) century, as governments infringed on the medical profession, even the Liberal Democracies have not been immune to the corruption of ethics in science and medicine. PMID:25324975

  15. Ethical considerations regarding early liver transplantation in patients with severe alcoholic hepatitis not responding to medical therapy.

    PubMed

    Donckier, Vincent; Lucidi, Valerio; Gustot, Thierry; Moreno, Christophe

    2014-04-01

    A recent study proposed that liver transplantation may represent life-saving treatment in patients with severe alcoholic hepatitis not responding to medical therapy. In this pilot experience, stringent patient selection resulted in major improvement of short-term survival with low rates of post-transplant alcohol relapse. In the context of organ shortage, which imposes a need for strict selection of transplant candidates, these results raise major ethical questions. Reluctance to perform liver transplantation in alcoholics is based on the fact that alcoholism is frequently considered to be self-inflicted and on fears of harmful post-transplant alcoholism recurrence. A minimal interval of sobriety lasting at least 6 months is a widely adopted criterion for the selection of patients with alcoholic liver disease for liver transplantation. In severe alcoholic hepatitis, the disastrous short-term prognosis in patients not responding to medical therapy does not allow one to reasonably impose an arbitrary period of 6-months of abstinence. This means that these patients must be either systematically excluded from transplantation or selected according to other criteria. Without significant pre-transplant abstinence, it might be argued that these patients do not merit a graft as they have not demonstrated their ability to gain control over their disease through durable modification of their behaviour. Consequently, this procedure could have a negative impact in the public, affecting organ donation and confidence in the fairness of transplant programs. In contrast, ethical principles recommend active treatment of patients, without discrimination, according to the best scientific knowledge. At this stage, we propose that there are no major ethical barriers for further evaluation of this new therapeutic option. The next steps should include transparent communication with the public and further studies to reproduce these results and identify the selection criteria that provide the best long-term outcomes. PMID:24291238

  16. [What a surgeon needs to know of the work of a medical ethics committee/institutional review board].

    PubMed

    Beck, N

    2015-02-01

    Ethical committees or institutional review boards are interdisciplinary committees to assess the ethical, social, legal and medical aspects of research involving human subjects. The ethics commission is to protect both the patient as well as the investigators and other personnel involved in the implementation of scientific projects. According to the professional code (Berufsordnung) every physician is obliged to consult an ethics committee to get a an approval before carrying out a research project. Concerning the Declaration of Helsinki, the advice of physicians is an international standard before carrying out a research project. In addition to the advisory function the ethics committee has an authorisation function within the pharmaceutical and medical device law. In the present publication the advisory and authorisation functions of an German ethics committee are briefly explained. PMID:24643787

  17. Ethics.

    ERIC Educational Resources Information Center

    Dansby-Giles, Gloria

    2002-01-01

    Making ethical decision rarely involves a simple yes or no answer. Matters of confidentiality are no different. This article examines how school counselors must draw the line between protecting a student's privacy and providing information to parents and administrators. (GCP)

  18. Simulation-Based Medical Education: An Ethical Imperative.

    ERIC Educational Resources Information Center

    Ziv, Amitai; Wolpe, Paul Root; Small, Stephen D.; Glick, Shimon

    2003-01-01

    Describes simulation-based learning in medical education and presents four these that make a framework for simulations: (1) best standards of care and training; (2) error management and patient safety; (3) patient autonomy; and (4) social justice and resource allocation. (SLD)

  19. One Chairperson's Experience of Ethical Review: Balancing Principle, Convention, Relationship and Risk in Educational Research

    ERIC Educational Resources Information Center

    O'Neill, John

    2010-01-01

    The author's experience of ethical review over six years as an academic member and chairperson of a university human ethics committee has been largely positive and educative. The account brings together archival records and personal experience to create a "transactive" account of the practical experience of doing ethical review in one university…

  20. Survey on Ethical Conduct Thresholds in Cardiologal Medical Practice in Argentina.

    PubMed

    Doval, Hernán C; Tajer, Carlos D; Borracci, Raúl A; Nuñez, Carmen; Samarelli, Marisa; Tamini, Susana

    2015-08-01

    The purpose of this study was to analyze the attitude of a group of cardiologists on the ethical conducts they would accept or adopt when encountered with different hypothetical situations of medical practice. Between August and September of 2011, 700 Argentine cardiologists were surveyed in situations which posed ethical dilemmas in the patient-physician relationship, among colleagues or involving financial agreements with employers or the pharmaceutical industry. Ethical conflicts were evidenced in a series of inappropriate conducts such as differential fees, trips and meals sponsored by laboratories, splitting fees, overbilling, self-referral, charging for patient referral, financial compensation for ordering medical procedures, and various situations derived from the relationship with employers. In general, financial compensation from the pharmaceutical industry was more accepted than the conflictive situations which directly involved patients, colleagues or employers. The rejection of these conducts, the physicians' deontological education and the improvement of financial and organizational conditions in medical practice will help to encourage better medical professionalism and avoid unseemly behaviors. PMID:23594285

  1. Medical and professional ethics in sixteenth-century Istanbul: towards an understanding of the relationships between the Ottoman State and the medical guilds.

    PubMed

    Shefer, Miri

    2002-01-01

    This paper contributes to the understanding of Ottoman medical guilds, their relationship with the government, and the role played by medical ethics in this framework. Decrees by the sultans (sing. ferm?n), issued in the Ottoman Imperial Council (Div?n) in Istanbul during the sixteenth century, concern themselves also with medical and ethical issues. The sheer number of these decrees may give the erroneous impression that the quality of medicine in the Ottoman Empire was low. This paper argues, however, that many of the complaints brought before the Ottoman authorities were instigated by medical guilds' members against their colleagues and competitors, not by aggravated patients demanding compensation from negligent healers. The discourse of medical ethics was raised in these cases not for its own sake, rather it embodied efforts by medical guild members to defend their economic interests and their intellectual and social status in the brutal competition in the medical realm. PMID:12184609

  2. Pre-modern Islamic medical ethics and Graeco-Islamic-Jewish embryology.

    PubMed

    Ghaly, Mohammed

    2014-02-01

    This article examines the, hitherto comparatively unexplored, reception of Greek embryology by medieval Muslim jurists. The article elaborates on the views attributed to Hippocrates (d. ca. 375 BC), which received attention from both Muslim physicians, such as Avicenna (d. 1037), and their Jewish peers living in the Muslim world including Ibn Jumay' (d. ca. 1198) and Moses Maimonides (d. 1204). The religio-ethical implications of these Graeco-Islamic-Jewish embryological views were fathomed out by the two medieval Muslim jurists Shih?b al-D?n al-Qar?f? (d. 1285) and Ibn al-Qayyim (d. 1350). By putting these medieval religio-ethical discussions into the limelight, the article aims to argue for a two-pronged thesis. Firstly, pre-modern medical ethics did exist in the Islamic tradition and available evidence shows that this field had a multidisciplinary character where the Islamic scriptures and the Graeco-Islamic-Jewish medical legacy were highly intertwined. This information problematizes the postulate claiming that medieval Muslim jurists were hostile to the so-called 'ancient sciences'. Secondly, these medieval religio-ethical discussions remain playing a significant role in shaping the nascent field of contemporary Islamic bioethics. However, examining the exact character and scope of this role still requires further academic ventures. PMID:23844565

  3. On the ethics of withholding and withdrawing medical treatment.

    PubMed

    Reichlin, Massimo

    2014-01-01

    A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it. PMID:25057360

  4. On the ethics of withholding and withdrawing medical treatment

    PubMed Central

    2014-01-01

    A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it. PMID:25057360

  5. Health, wealth and fairness based on gender: the support for ethical principles.

    PubMed

    MÃ¥nsdotter, Anna; Lindholm, Lars; Lundberg, Michael

    2006-05-01

    Sex differences in health, and the reality of a gender system, are well-known, but we know little about how this connects to opinions on fairness and desired change. This study aims to explore two principal questions: how to compare the position of women and men within-state and how to choose between-states, where a state is defined as a situation in which individuals have a particular set of resources, rights and duties, and if components in the set are altered, a new state for the same individuals appears. Based on various normative rules (monistic view or separate spheres, equity as choice or ethics of care, equity by attainment or shortfall; variants of welfarism, feminism and conservatism), a survey among Swedish public health workers was carried out. The results demonstrate a major rejection of the idea of compensation between health, power, influence and resources, and of considering past processes when judging fairness as to women and men. Moreover, most respondents believe that a biologically based difference in health is fair and reject health maximization as a guiding principle. The support for gender equality is strong when contrasted with the conservative goal, and subsists when contrasted against the Pareto criterion and trading-off health/income as well. Results that call for additional research and exchange of views include that common notions in research and policy-making are rejected by a majority, and that females and males differ considerably when judging change from a societal perspective. PMID:16332405

  6. [Fundamental ethical principles in the European framework programmes for research and development].

    PubMed

    Hirsch, François; Karatzas, Isidoros; Zilgalvis, P?teris

    2009-01-01

    The European Commission is one of the most important international funding bodies for research conducted in Europe and beyond, including developing countries and countries in transition. Through its framework programmes for research and development, the European Union finances a vast array of projects concerning fields affecting the citizens' health, as well as the researchers' mobility, the development of new technologies or the safeguard of the environment. With the agreement of the European Parliament and of the Council of Ministers, the two decisional authorities of the European Union, the 7th framework programmes was started on December 2006. This program has a budget of 54 billion Euros to be distributed over a 7-year period. Therefore, the European Union aims to fully address the challenge as stated by the European Council of Lisbon (of March 2000) which declared the idea of providing 3% of the GDP of all the Member States for the purpose of research and development. One of the important conditions stated by the Members of the European Parliament to allocate this financing is to ensuring that "the funding research activities respect the fundamental ethical principles". In this article, we will approach this aspect of the evaluation. PMID:19765393

  7. The static evolution of the new Italian code of medical ethics.

    PubMed

    Montanari Vergallo, G; Busardò, F P; Zaami, S; Marinelli, E

    2016-02-01

    Eight years since the last revision, in May 2014 the Italian code of medical ethics has been updated. Here, the Authors examine the reform in the light of the increasing difficulties of the medical profession arising from the severity of the Italian law Courts. The most significant aspects of this new code are firstly, the patient's freedom of self-determination and secondly, risk prevention through the disclosure of errors and adverse events. However, in both areas the reform seems to be less effective if we compare the ethical codes of France, the United Kingdom and the United States. In particular, the non-taking into consideration of the said code quality standards and scientific evidence which should guide doctors in their clinical practice is to say the least questionable. Since these are the most significant changes in the new code, it seems inevitable to conclude that the 2014 edition is essentially in line with previous versions. Now more than ever it is necessary that medical ethics acknowledges that medicine, society and medical jurisprudence have changed and doctors must be given new rules in order to protect both patients' rights and dignity of the profession. The physician's right to refuse to perform treatment at odds with his own clinical beliefs cannot be the only mean to safeguard the dignity of the profession. A clear boundary must also be established between medicine and professionalism as well as the criteria in determining the scientific evidences that physicians must follow. This has not been done in the Italian code of ethics, despite all the controversy caused by the Stamina case. PMID:26914136

  8. Research ethics and the medical profession. Report of the Advisory Committee on Human Radiation Experiments.

    PubMed

    1996-08-01

    The Advisory Committee on Human Radiation Experiments was convened by President Clinton in January 1994 in response to allegations of unethical practices in radiation experiments involving human subjects that were sponsored by the US government between 1944 and 1974. The committee's Final Report was released in October 1995. In addition to analyzing the history of the ethics of medical research involving human subjects, the committee reviewed current federal policies and procedures for protection of human subjects. In this article, the committee's findings are discussed as they relate to the patient-physician relationship, the issue of trust, and the specific role of the physician-investigator in all types of human experimentation. The committee found evidence of discussion of the conduct of human research at the highest levels of the government and within the medical profession, particularly with regard to risk, during the 1940s and 1950s. However, in both federal policy and professional practice, requirements for consent were more likely to apply to "healthy volunteers" than to patient-subjects (ie, those with disease or illness). Today, consensus exists that duties to obtain informed consent apply to all human subjects, whether healthy or sick, regardless of the risk or potential for medical benefit from participation in the research and regardless of the nature of sponsorship or funding (eg, federal, military, or private). Based on a finding of serious deficiencies in the current system of protections for human subjects, the committee offers a number of recommendations, including changes in institutional review boards; in the interpretation of ethics rules and policies; in oversight, accountability, and sanctions for ethics violations; and in compensation for research injuries. More than public policy changes, however, the committee recommends that the medical profession intensify its commitment to the ethics of research involving human subjects. PMID:8683820

  9. Paradoxical traps in therapeutics: some dilemmas in medical ethics.

    PubMed Central

    Lowental, U

    1979-01-01

    The doctor-patient relationship is examined an emphasis on the comparison between professional and moral principles. Many therapeutic measures have opposite-directed alternative steps with an equal degree of justification, so that no logical preference is attainable and conflicts ensue. Thus patients come for relief and are ordered to endure further pain and discomfort; or weaker individuals exaggerate their complaints hypochomdriacally, and thus need a great deal of understanding, yet paradoxically they are prone to receive less support than stronger ones. Further conflicts arise between our devotion to human well-being and dignity, and our obligation to disrespect some of their rights for self-determination. Furthermore, various dutifully performed doctoring activities run counter to our own social needs and interests; last, but not least, human imperfection colours some of our decisions, putting a definite blemish on their value. In conclusion, physicians must bear the constant burden of paradoxically-opposed alternatives, and they confront pitfalls of worongdoing at every therapeutic step. Their only guidelines are intuition and professional dedication. PMID:430522

  10. Professional Ethics in Astronomy: The AAS Ethics Statement

    NASA Astrophysics Data System (ADS)

    Marvel, Kevin B.

    2013-01-01

    It is fundamental to the advancement of science that practicing scientists adhere to a consistent set of professional ethical principles. Recent violations of these principles have led a decreased trust in the process of science and scientific results. Although astronomy is less in the spotlight on these issues than medical science or climate change research, it is still incumbent on the field to follow sound scientific process guided by basic ethical guidelines. The American Astronomical Society, developed a set of such guidelines in 2010. This contribution summarizes the motivation and process by which the AAS Ethics Statement was produced.

  11. The doctor and the market: about the influence of market reforms on the professional medical ethics of surgeons and general practitioners in the Netherlands.

    PubMed

    Dwarswaard, Jolanda; Hilhorst, Medard; Trappenburg, Margo

    2011-12-01

    To explore whether market reforms in a health care system affect medical professional ethics of hospital-based specialists on the one hand and physicians in independent practices on the other. Qualitative interviews with 27 surgeons and 28 general practitioners in The Netherlands, held 2-3 years after a major overhaul of the Dutch health care system involving several market reforms. Surgeons now regularly advertise their work (while this was forbidden in the past) and pay more attention to patients with relatively minor afflictions, thus deviating from codes of ethics that oblige physicians to treat each other as brothers and to treat patients according to medical need. Dutch GPs have abandoned their traditional reticence and their fear of medicalization. They now seem to treat more in accordance with patients' preferences and less in accordance with medical need. Market reforms do affect medical professional principles, and it is doubtful whether these changes were intended when Dutch policy makers decided to introduce market elements in the health care system. Policy makers in other countries considering similar reforms should pay attention to these results. PMID:21267659

  12. Theodore E. Woodward Award. HIV/AIDS, ethics, and medical professionalism: where went the debate?

    PubMed

    Bryan, Charles S

    2003-01-01

    The recent surge of dialogue about medical professionalism has largely ignored HIV/AIDS, perhaps because the ethical issues that abounded during the 1980s and early 1990s have become largely passé. Prior to the introduction of highly active antiretroviral therapy (HAART) in 1996, the care ethic for patients with HIV/AIDS depended heavily on compassion since effective treatment was unavailable. Moreover, physicians and other health care workers often assumed physical risks on behalf of patients. HAART transformed the care ethic for HIV/AIDS to one dependent mainly on medical competence. Reflecting on the epidemic, I propose a distinction between "basic" and "higher" professionalism. Basic professionalism requires discipline-specific competence, facilitated by adherence to the four cardinal virtues (prudence, temperance, justice, and courage). Higher professionalism brings into play the transcendent virtues: faith, hope, and--especially--love (compassion). Specific examples of "compassion" in the strict sense of "suffering with" include caring without adequate reimbursement, caring when one would rather be doing something else, and assuming emotional or physical risks on behalf of patients. The physicians and other health care workers who displayed such compassion in abundance between 1981 and 1996 deserve our remembrance as exemplars of a higher professionalism. PMID:12813930

  13. Practical divinity and medical ethics: lawful versus unlawful medicine in the writings of William Perkins (1558-1602).

    PubMed

    Gevitz, Norman

    2013-04-01

    This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between "lawful" and "unlawful" medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons. PMID:22235029

  14. Ethical arguments for and against sperm sorting for non-medical sex selection: a review.

    PubMed

    Kalfoglou, A L; Kammersell, M; Philpott, S; Dahl, E

    2013-03-01

    Much has been written about the ethics of sex selection. This article thoroughly explores the ethical arguments put forth in the literature both for and against non-medical sex selection using sperm sorting. While most of these arguments come from philosophers, feminist scholars, social scientists and members of the healthcare community, they are often echoed in empirical studies that have explored community values. This review is timely because the first efficacious method for sex selection via sperm sorting, MicroSort, is currently in clinical trials and moving closer to FDA approval for marketing in the USA. While the clinical trials are currently focused on the use of MicroSort to avoid X-linked genetic diseases, MicroSort can also be used to satisfy parental preferences. PMID:23337421

  15. Problems in deceptive medical procedures: an ethical and legal analysis of the administration of placebos

    PubMed Central

    Simmons, Beth

    1978-01-01

    The use of placebos in therapy or research poses ethical questions. What are the benefits and the costs in ethical terms of condoning deception of the patient or subject? What does the deception mean for the patient's or subject's right to give informed consent to his treatment? Doctors are rightly expected to disclose to their patient facts which would in their judgement best enable him to give informed consent to treatment. On occasion, the degree of this disclosure may be limited by the need to avoid hazarding the success of treatment of an unstable patient whose condition threatens his life, but doctors should have no right to withhold information just to prevent a patient refusing consent to therapy. No such limitation should apply in experiments where full disclosure must operate to enable the subject to give his informed consent. The potential medical benefits for the patient of placebo therapy have to be weighed against all the ethical costs of the deception and dishonesty involved, including the longer term repercussions on doctor/patient trust: similar ethical costs may arise in experiments involving the use of placebos without disclosure of this as a possibility to the subject. Deception is ethically degrading to both parties not only being a breach of trust, but denying the moral autonomy of the patient or subject to make his own choice. The writer concludes that placebos should be used only with full disclosure and consent whether in therapy or in research, and that this need not impede the success of either. PMID:739513

  16. Emergency department triage: an ethical analysis

    PubMed Central

    2011-01-01

    Background Emergency departments across the globe follow a triage system in order to cope with overcrowding. The intention behind triage is to improve the emergency care and to prioritize cases in terms of clinical urgency. Discussion In emergency department triage, medical care might lead to adverse consequences like delay in providing care, compromise in privacy and confidentiality, poor physician-patient communication, failing to provide the necessary care altogether, or even having to decide whose life to save when not everyone can be saved. These consequences challenge the ethical quality of emergency care. This article provides an ethical analysis of "routine" emergency department triage. The four principles of biomedical ethics - viz. respect for autonomy, beneficence, nonmaleficence and justice provide the starting point and help us to identify the ethical challenges of emergency department triage. However, they do not offer a comprehensive ethical view. To address the ethical issues of emergency department triage from a more comprehensive ethical view, the care ethics perspective offers additional insights. Summary We integrate the results from the analysis using four principles of biomedical ethics into care ethics perspective on triage and propose an integrated clinically and ethically based framework of emergency department triage planning, as seen from a comprehensive ethics perspective that incorporates both the principles-based and care-oriented approach. PMID:21982119

  17. Deliberation at the hub of medical education: beyond virtue ethics and codes of practice.

    PubMed

    Barilan, Y M; Brusa, M

    2013-02-01

    Although both codes of practice and virtue ethics are integral to the ethos and history of "medical professionalism", the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians' "burn-out". We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation. PMID:22740074

  18. Telemedicine as an ethics teaching tool for medical students within the nephrology curriculum.

    PubMed

    Bramstedt, Katrina A; Prang, Melissa; Dave, Sameer; Shin, Paul Ng Hung; Savy, Amani; Fatica, Richard A

    2014-09-01

    A novel patient-centered approach was used to deliver ethics curriculum to medical students. Two medical school clinicians designed a telemedicine session linking their facilities (across 2 continents). The session, Exploring the Patient Experience Through Telemedicine: Dialysis and End-Stage Renal Disease, allowed second-year medical students to explore various parameters of quality of life experienced by dialysis patients. A panel of 4 medical students interviewed a dialysis patient via Skype video connection between the medical school and the hospital's dialysis unit. Interview questions were adapted from the Kidney Disease Quality of Life instrument. During the live video-streamed interview, the remaining 23 second-year medical students observed the session. Afterward, the 23 were offered a voluntary anonymous online feedback survey (15 responded). The 4 panelists submitted narrative responses to 2 open-ended questions about their experience. All 15 responding students "Strongly agreed" or "Agreed" that the session was an aid to their professionalism skills and behaviors; 14 of 15 "Strongly agreed" or "Agreed" that telemedicine technology contributed to their understanding of the topic; 12 of 15 "Strongly agreed" that the session improved their understanding of the psychosocial burdens of dialysis, quality of life, and human suffering, and increased their empathy toward patients; and 12 of 15 "Strongly agreed" or "Agreed" that the session encouraged reflective thinking and was an aid to improving their communication skills. Telemedicine can be an effective and feasible method to deliver an ethics curriculum with a patient-centered approach. Additionally, the cross-cultural experience exposes students to additional contextual features of medicine. PMID:25193732

  19. 'God's ethicist': Albert Moll and his medical ethics in theory and practice.

    PubMed

    Maehle, Andreas-Holger

    2012-04-01

    In 1902, Albert Moll, who at that time ran a private practice for nervous diseases in Berlin, published his comprehensive book on medical ethics, Ärztliche Ethik. Based on the concept of a contractual relationship between doctor and client, it gave more room to the self-determination of patients than the contemporary, usually rather paternalistic, works of this genre. In the first part of the present paper this is illustrated by examining Moll's views and advice on matters such as truthfulness towards patients, euthanasia, and abortion. The second part of this article discusses how Moll engaged with the then publicly debated issues of experimentation on hospital patients and the 'trade' of foreign private patients between agents and medical consultants. In both matters Moll collected evidence of unethical practices and tried to use it to bring about change without damaging his or the profession's reputation. However, with his tactical manoeuvres, Moll made no friends for himself among his colleagues or the authorities; his book on ethics also met with a generally cool response from the medical profession and seems to have been more appreciated by lawyers than by other doctors. PMID:23002294

  20. ‘God’s Ethicist’: Albert Moll and His Medical Ethics in Theory and Practice

    PubMed Central

    Maehle, Andreas-Holger

    2012-01-01

    In 1902, Albert Moll, who at that time ran a private practice for nervous diseases in Berlin, published his comprehensive book on medical ethics, Ärztliche Ethik. Based on the concept of a contractual relationship between doctor and client, it gave more room to the self-determination of patients than the contemporary, usually rather paternalistic, works of this genre. In the first part of the present paper this is illustrated by examining Moll’s views and advice on matters such as truthfulness towards patients, euthanasia, and abortion. The second part of this article discusses how Moll engaged with the then publicly debated issues of experimentation on hospital patients and the ‘trade’ of foreign private patients between agents and medical consultants. In both matters Moll collected evidence of unethical practices and tried to use it to bring about change without damaging his or the profession’s reputation. However, with his tactical manoeuvres, Moll made no friends for himself among his colleagues or the authorities; his book on ethics also met with a generally cool response from the medical profession and seems to have been more appreciated by lawyers than by other doctors. PMID:23002294

  1. An Invitation for Medical Educators To Focus on Ethical and Policy Issues in Research and Scholarly Practice.

    ERIC Educational Resources Information Center

    Roberts, Laura Weiss; Geppert, Cynthia; Connor, Renee; Nguyen, Khanh; Warner, Teddy D.

    2001-01-01

    Reviewed medical education research reports published in 1988 and 1989 and in 1998 and 1999 in two major medical education journals for documentation of six ethically important safeguards and features (e.g., informed consent). Rates of reporting were low and did not increase substantially after 10 years, raising implications for faculty, training…

  2. The Role of Academic Psychiatry Faculty in the Treatment and Subsequent Evaluation and Promotion of Medical Students: An Ethical Conundrum

    ERIC Educational Resources Information Center

    Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.

    2008-01-01

    Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The…

  3. From Cure to Care: Assessing the Ethical and Professional Learning Needs of Medical Learners in a Care-Based Facility

    ERIC Educational Resources Information Center

    Hall, Pippa; O'Reilly, Jane; Dojeiji, Sue; Blair, Richard; Harley, Anne

    2009-01-01

    The purpose of this study was to assess the ethical and professional learning needs of medical trainees on clinical placements at a care-based facility, as they shifted from acute care to care-based philosophy. Using qualitative data analysis and grounded theory techniques, 12 medical learners and five clinical supervisors were interviewed. Five…

  4. [The bought patient : The ethical value of per capita flat rates from a medical viewpoint].

    PubMed

    Hakenberg, O W

    2009-08-01

    Payments received by private physicians per patient sent for hospital treatment are a relatively new phenomenon in the German medical system. This practice has been made possible by the currently aggressive competition between hospitals. The practice of such regular payments has several legal as well as ethical aspects. It needs to be clarified whether and in which cases such payments constitute a justified fee for a valuable and necessary service or whether they simply represent an element of corruption which is used to generate case numbers in a competitive market situation. PMID:19585098

  5. General Principles of Radiation Protection in Fields of Diagnostic Medical Exposure

    PubMed Central

    2016-01-01

    After the rapid development of medical equipment including CT or PET-CT, radiation doses from medical exposure are now the largest source of man-made radiation exposure. General principles of radiation protection from the hazard of ionizing radiation are summarized as three key words; justification, optimization, and dose limit. Because medical exposure of radiation has unique considerations, diagnostic reference level is generally used as a reference value, instead of dose limits. In Korea, medical radiation exposure has increased rapidly. For medical radiation exposure control, Korea has two separate control systems. Regulation is essential to control medical radiation exposure. Physicians and radiologists must be aware of the radiation risks and benefits associated with medical exposure, and understand and implement the principles of radiation protection for patients. The education of the referring physicians and radiologists is also important. PMID:26908991

  6. Religious, Ethical and Legal Considerations in End-of-Life Issues: Fundamental Requisites for Medical Decision Making.

    PubMed

    Jahn Kassim, Puteri Nemie; Alias, Fadhlina

    2016-02-01

    Religion and spirituality have always played a major and intervening role in a person's life and health matters. With the influential development of patient autonomy and the right to self-determination, a patient's religious affiliation constitutes a key component in medical decision making. This is particularly pertinent in issues involving end-of-life decisions such as withdrawing and withholding treatment, medical futility, nutritional feeding and do-not-resuscitate orders. These issues affect not only the patient's values and beliefs, but also the family unit and members of the medical profession. The law also plays an intervening role in resolving conflicts between the sanctity of life and quality of life that are very much pronounced in this aspect of healthcare. Thus, the medical profession in dealing with the inherent ethical and legal dilemmas needs to be sensitive not only to patients' varying religious beliefs and cultural values, but also to the developing legal and ethical standards as well. There is a need for the medical profession to be guided on the ethical obligations, legal demands and religious expectations prior to handling difficult end-of-life decisions. The development of comprehensive ethical codes in congruence with developing legal standards may offer clear guidance to the medical profession in making sound medical decisions. PMID:25576401

  7. Preimplantation genetic diagnosis (PGD) according to medical ethics and medical law

    PubMed Central

    Lutz, Emine Elif Vatano?lu

    2012-01-01

    Assisted reproductive techniques not only nourish great and sometimes illusive hopes of couples who yearn for babies, but also spark new debates by reversing opinions, beliefs and values. Applications made to infertility clinics are increasing due to the influences such as broadcasts made by the media concerning assisted reproductive techniques and other infertility treatments, increase in the knowledge that people have about these problems, late marriages and postponement of childbearing age owing to sociological changes. Pre-implantation genetic diagnosis (PGD) is a technique applied to couples who are known to carry genetic diseases or who have children with genetic diseases. This technique is conducted by doctors in Turkey for its important contribution to decreasing the risk of genetic diseases and in order to raise healthy generations. In this paper, the general ethical debates and the legal situation in Turkey will be discussed. PMID:24627675

  8. Towards a Confucian virtue bioethics: reframing Chinese medical ethics in a market economy.

    PubMed

    Fan, Ruiping

    2006-01-01

    This essay addresses a moral and cultural challenge facing health care in the People's Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition's account of how virtue and human flourishing are compatible with the pursuit of profit. It offers the Confucian account of the division of labor and the financial inequalities this produces with special attention to China's socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics. PMID:17136438

  9. A study of promotional advertisements of drugs in a medical journal: an ethics perspective.

    PubMed

    Nath, Sarmila; Bhowmick, Subhrojyoti; Dutta, Trayambak; Chowrasia, V R; Bhattacharya, Shipra; Chatterjee, R N; Sarkar, Manjula; Ram, A K; Mukherjee, P K

    2014-01-01

    The study assessed 54 advertisements of 145 different drugs, published over one year (from December 2011 to November 2012) in an Indian medical journal, circulated widely mainly among general practitioners (GPs). The ethical guidelines of the World Health Organization (WHO) and Organisation of Pharmaceutical Producers of India (OPPI) for medicinal drug promotion were applied. The brand name was mentioned in all advertisements (100% compliance both with the WHO and OPPI criteria) and the names of the active ingredients were also mentioned in 128 (90.14%) advertisements. However, major adverse drug reactions were mentioned in only two advertisements (1.37%); precautions, contraindications and warnings in only two (1.37%); and major interactions in only one (0.68%). Only three advertisements (2.06%) were well substantiated with references. To ensure the ethical promotionof drugs among GPs, journals must introduce compulsory review and appraisal of promotional advertisements by a dedicated review board, including at least one member trained in pharmacology and one representative from the medical division of a pharmaceutical company. PMID:25377037

  10. The debate about physician assistance in dying: 40 years of unrivalled progress in medical ethics?

    PubMed

    Holm, Søren

    2015-01-01

    Some issues in medical ethics have been present throughout the history of medicine, and thus provide us with an opportunity to ascertain: (1) whether there is progress in medical ethics; and (2) what it means to do good medical ethics. One such perennial issue is physician assistance in dying (PAD). This paper provides an account of the PAD debate in this journal over the last 40 years. It concludes that there is some (but limited) progress in the debate. The distinctions, analogies and hypothetical examples have proliferated, as have empirical studies, but very little has changed in terms of the basic arguments. The paper further argues that many of the contributions to the debate fail to engage fully with the concerns people have about the legal introduction of PAD in the healthcare system, perhaps because many of the contributions sit on the borderline between academic analysis and social activism. PMID:25516932

  11. The ethics of secondary data analysis: considering the application of Belmont principles to the sharing of neuroimaging data.

    PubMed

    Brakewood, Beth; Poldrack, Russell A

    2013-11-15

    The sharing of data is essential to increasing the speed of scientific discovery and maximizing the value of public investment in scientific research. However, the sharing of human neuroimaging data poses unique ethical concerns. We outline how data sharing relates to the Belmont principles of respect-for-persons, justice, and beneficence. Whereas regulators of human subjects research often view data sharing solely in terms of potential risks to subjects, we argue that the principles of human subject research require an analysis of both risks and benefits, and that such an analysis suggests that researchers may have a positive duty to share data in order to maximize the contribution that individual participants have made. PMID:23466937

  12. The challenges and ethical dilemmas of a military medical officer serving with a peacekeeping operation in regard to the medical care of the local population.

    PubMed

    Tobin, J

    2005-10-01

    Medical Officers serving with their national contingents in peacekeeping operations are faced with difficult ethical decisions in regard to their obligations to the local civilian population. Such populations may be under-resourced in regard to medical care, and vulnerable to abuse and exploitation. Though the medical officer may support the local medical services, he/she should never undermine these resources. Adopting a human rights approach and observing the requirements of ethical medicine, aids the doctor in prioritising his/her duties. At times there may be conflict with one's own military superiors. It is wise to discuss potential difficulties prior to setting out on the mission. Human rights abuses cannot be ignored. The medical officer has a duty to do his/her best to report their observations so as to prevent abuse or to bring it to an end. PMID:16199596

  13. Palliative care versus euthanasia. The German position: the German General Medical Council's principles for medical care of the terminally ill.

    PubMed

    Sahm, S W

    2000-04-01

    In September 1998 the Bundesärztekammer, i.e., the German Medical Association, published new principles concerning terminal medical care. Even before publication, a draft of these principles was very controversial, and prompted intense public debate in the mass media. Despite some of the critics' suspicions that the principles prepared the way for liberalization of active euthanasia, euthanasia is unequivocally rejected in the principles. Physician-assisted suicide is considered to violate professional medical rules. In leaving aside some of the notions customarily used in the euthanasia debate, e.g., passive euthanasia, the principles emphasize the obligation of physicians to offer and the right of patients to receive palliative care. The principles explicitly list modalities of basic treatment that are indispensable in all cases, such as the obligation to satisfy hunger and thirst. This statement is meant to resolve the dispute on nutrition and hydration at the end of life, as it shifts the focus of care from maintaining physiological parameters to satisfying subjective needs. For patients in a persistent vegetative state, artificial feeding is held to be obligatory. Yet, the principles make reference to recent German jurisdiction which permit the stopping of artificial feeding if it is in accordance with the patient's presumed will. Additionally, the wording concerning this issue is found to remain unclear. Patients' autonomy is strengthened by explicitly welcoming advance directives as a means to ascertain patients' wills. The principles mark some changes compared to earlier documents. They deserve careful analysis and should be considered in the international debate on issues concerning the end of life. PMID:10833136

  14. [Intensive care - palliative care. Contradiction or supplement? Considerations on ethical issues and principles in the treatment of dying patients].

    PubMed

    Müller-Busch, H C

    2001-12-01

    Over the last five decades the progress in intensive care has extended the limitations of controlling the process of dying and given doctors more influence in determining the time of death. More recently, palliative care has emerged as a new approach in response to the ethical dilemmas of modern medicine, which accepts that dying is a natural process that should not be hastened or delayed through medical interventions. While in Germany in 1999 more than 50 000 people have died in intensive care units, only a small number of 8000 patients have died in palliative care. In comparison to the highly-developed intensive care sector, palliative care is a much neglected area. The public debate following the legalisation of euthanasia in the Netherlands has highlighted concerns in Germany that intensive care has the potential of inappropriately prolonging life and raised expectations about the alternative therapies offered by palliative care. Doctors in intensive care and in palliative care face similar ethical dilemmas, though with a different weighting: the dilemma between professional judgement and patient autonomy, between traditional medical roles and patient self-determination and the dilemma of extending the span of life at the expense of quality of life. The approach of palliative care with its strong focus on alleviating the suffering of the terminally ill, has influenced the ethical debate of dying in intensive care. Although intensive care and palliative care have different aims and priorities, there are common problems of decision-making which could benefit from a shared orientation and interdisciplinary debate. Both the interpretation of a dying parent's will as well as withdrawing or withholding treatment in patients who are unable to decide for themselves should not merely be guided by the debate on active and passive euthanasia, but rather take into account the appropriateness or inappropriateness of medical actions in the specific situation. PMID:11743668

  15. School Psychology: How Universal Are Ethical Principles Approved by International Associations?

    ERIC Educational Resources Information Center

    Pettifor, Jean L.

    2004-01-01

    Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics and competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise.…

  16. Action Research in Education: Addressing Gaps in Ethical Principles and Practices

    ERIC Educational Resources Information Center

    Nolen, Amanda L.; Putten, Jim Vander

    2007-01-01

    Action research in education has gained increasing attention in the past 20 years. It is viewed as a practical yet systematic research method that enables teachers to investigate their own teaching and their students' learning. However, the ethical issues unique to this form of insider research have received less attention. Drawing on several…

  17. School Psychology: How Universal Are Ethical Principles Approved by International Associations?

    ERIC Educational Resources Information Center

    Pettifor, Jean L.

    2004-01-01

    Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics and competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise.…

  18. Resolving a Conflict between APA Learning Goals and APA Ethical Principles

    ERIC Educational Resources Information Center

    Corty, Eric W.

    2008-01-01

    Although American Psychological Association (APA) Ethical Standards make it clear that instructors cannot require students to disclose personal information in class-related activities, an APA learning goal for undergraduate psychology students is that they reflect on their experiences to develop insight into their behavior and mental processes.…

  19. Integrating Values and Ethics into Post Secondary Teaching for Leadership Development: Principles, Concepts, and Strategies

    ERIC Educational Resources Information Center

    Begley, Paul T.; Stefkovich, Jacqueline

    2007-01-01

    Purpose: The purpose of this paper is to explore the nature of moral literacy as it applies to leadership development and the processes for promoting moral literacy through teaching in colleges and universities. Design/methodology/approach: The ethics of authenticity and moral agency in education settings are proposed as a means for promoting and…

  20. Foundational Security Principles for Medical Application Platforms* (Extended Abstract)

    PubMed Central

    Vasserman, Eugene Y.; Hatcliff, John

    2014-01-01

    We describe a preliminary set of security requirements for safe and secure next-generation medical systems, consisting of dynamically composable units, tied together through a real-time safety-critical middleware. We note that this requirement set is not the same for individual (stand-alone) devices or for electronic health record systems, and we must take care to define system-level requirements rather than security goals for components. The requirements themselves build on each other such that it is difficult or impossible to eliminate any one of the requirements and still achieve high-level security goals. PMID:25599096

  1. The rise of empirical research in medical ethics: a MacIntyrean critique and proposal.

    PubMed

    Lawrence, Ryan E; Curlin, Farr A

    2011-04-01

    Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought. PMID:21339390

  2. Luxury Primary Care, Academic Medical Centers, and the Erosion of Science and Professional Ethics

    PubMed Central

    Donohoe, Martin

    2004-01-01

    Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice. Given widespread disparities in health, wealth, and access to care, as well as growing cynicism and dissatisfaction with medicine among trainees, the promotion by these institutions of an overt, two-tiered system of care, which exacerbates inequities and injustice, erodes professional ethics. Academic medical centers should divert their intellectual and financial resources away from luxury primary care and toward more equitable and just programs designed to promote individual, community, and global health. The public and its legislators should, in turn, provide adequate funds to enable this. Ways for academic medicine to facilitate this largesse are discussed. PMID:14748866

  3. Ethical dilemma of mandated contraception in pharmaceutical research at catholic medical institutions.

    PubMed

    Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd

    2012-01-01

    The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance. PMID:22694032

  4. Ethical precepts for medical volunteerism: including local voices and values to guide RHD surgery in Rwanda.

    PubMed

    Coors, Marilyn E; Matthew, Thomas L; Matthew, Dayna B

    2015-10-01

    At the invitation of the Rwandan Government, Team Heart, a team of American healthcare professionals, performs volunteer rheumatic heart disease (RHD) surgery in Rwanda every year, and confronts ethical concerns that call for cultural sensitivity. This article describes how five standard bioethical precepts are applied in practice in medical volunteerism related to RHD surgery in Rwanda. The content for the applied precepts stems from semiscripted, transcribed conversations with the authors, two Rwandan cardiologists, a Rwandan nurse and a Rwandan premedical student. The conversations revealed that the criteria for RHD surgical selection in Rwanda are analogous to the patient-selection process involving material scarcity in the USA. Rwandan notions of benefit and harm focus more attention on structural issues, such as shared benefit, national reputation and expansion of expertise, than traditional Western notions. Harm caused by inadequate patient follow-up remains a critical concern. Gender disparities regarding biological and social implications of surgical valve choices impact considerations of justice. Individual agency remains important, but not central to Rwandan concepts of justice, transparency and respect, particularly regarding women. The Rwandan understanding of standard bioethical precepts is substantively similar to the traditionally recognised interpretation with important contextual differences. The communal importance of improving the health of a small number of individuals may be underestimated in previous literature. Moreover, openness and the incorporation of Rwandan stakeholders in difficult ethical choices and long-term contributions to indigenous medical capacity appear to be valued by Rwandans. These descriptions of applied precepts are applicable to different medical missions in other emerging nations following a similar process of inclusion. PMID:26066361

  5. Principles of ethics and code of professional conduct with official advisory opinions revised to May 1992.

    PubMed

    1992-09-01

    The ethical statements which have historically been subscribed to by the dental profession have had the benefit of the patient as their primary goal. Recognition of this goal, and of the education and training of a dentist, has resulted in society affording to the profession the privilege and obligation of self-government. The Association calls upon members of the profession to be caring and fair in their contact with patients. Although the structure of society may change, the overriding obligation of the dentist will always remain the duty to provide quality care in a competent and timely manner. All members must protect and preserve the high standards of oral health care provided to the public by the profession. They must strive to improve the care delivered--through education, training, research and, most of all, adherence to a stringent code of ethics, structured to meet the needs of the patient. PMID:1517524

  6. Seeking evidence to support usability principles for medication-related clinical decision support (CDS) functions.

    PubMed

    Marcilly, Romaric; Beuscart-Zéphir, Marie-Catherine; Ammenwerth, Elske; Pelayo, Sylvia

    2013-01-01

    There is a need for evidence-based usability principles to support the design of usable medication-related computerized CDS functions and systems. Such evidence requires establishing scientific relationships between usability principles, their violation in terms of usability flaws, issuing usage problems and their consequences or outcomes in the clinical work and patient care. This kind of evidence is not currently directly available in scientific evaluation studies of medication CDS functions. A possible proxy to seek evidence is systematic review of existing scientific evaluation reports. We rely on a four-stage framework describing the chain of consequences and inferences linking usability principles to clinical outcomes to design the systematic review methodology and interpretation principles. This paper describes the four-stage framework and the resulting consequences for the systematic review design. PMID:23920590

  7. The medical ethics of Dr J Marion Sims: a fresh look at the historical record

    PubMed Central

    Wall, L L

    2006-01-01

    Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims's modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time. PMID:16731734

  8. Medical ethics educational improvement, is it needed or not?! Survey for the assessment of the needed form, methods and topics of medical ethics teaching course amongst the final years medical students Faculty of Medicine Ain Shams University (ASU), Cairo, Egypt 2010.

    TOXLINE Toxicology Bibliographic Information

    Fawzi MM

    2011-07-01

    INTRODUCTION: In the process of our faculty gaining accreditation, the debate concerning the necessity for initiating an integrated course in which medical ethics course is implemented have arouse. Arguments concerning what should this course include, the best timing for this course to be applied, how it should be taught, planned for and mostly for what the students are interested to get out of it.GOAL: The main purpose of this work is to identify the ethical needs and ethical dilemmas freshly graduated medical students face at the beginning of their training and their suggestions to seek better educational approaches that can be applied in teaching medical ethics proposed by the medical students themselves throughout the teaching process and after graduation.METHODS: It seemed rather appropriate at this stage to carry out an evaluation survey assessing the needs for medical ethics teaching course through the exploration of the opinions of medical students and freshly graduated doctors on ethical issues through a simple survey by using an open ended question questionnaire designed to fulfil the study targeted requirements.RESULTS: 100 volunteers (n = 100) randomly chosen from the fifth year students of our faculty of medicine ASU who had recently studied ethics course in the fourth year (n = 20), interns both junior and senior residents in El Demerdash hospitals (n = 80). 25 questionnaires were excluded due to inappropriate or missing answers resulting in 75% response rate. 60% of the surveyed group favored an integrated ethics course taught throughout the whole academic years study. 56% chose the practical teaching method with problem solving strategies for the daily arising confusing ethical issues to be the best way to teach the course. While 53.4% thought that stuff specialized in medico legal issues were best to teach this course. As regards the highly confusing ethical dilemmas in which they were interested in getting updated feedback about: Confidentiality, doctor-patient relationship and informed consent came first by 69.3%.CONCLUSIONS: This study revealed the essential need for a model medical ethics curriculum that responds to students' concerns in addition to providing basic training in moral reasoning and ethical decision making to be applied both horizontally and vertically across the whole years of medical school.RECOMMENDATIONS: A Simple booklet containing recent version of the Egyptian code of ethics, common ethical dilemmas and recently evolving ethical issues should be available for all newly graduated health professionals.

  9. Pragmatic and Ethical Challenges of Incorporating the Genome into the Electronic Medical Record

    PubMed Central

    Nishimura, Adam A.; Tarczy-Hornoch, Peter; Shirts, Brian H.

    2014-01-01

    Recent successes in the use of gene sequencing for patient care highlight the potential of genomic medicine. For genomics to become a part of usual care, pertinent elements of a patient's genomic test must be communicated to the most appropriate care providers. Electronic medical records may serve as a useful tool for storing and disseminating genomic data. Yet, the structure of existing EMRs and the nature of genomic data pose a number of pragmatic and ethical challenges in their integration. Through a review of the recent genome-EMR integration literature, we explore concrete examples of these challenges, categorized under four key questions: What data will we store? How will we store it? How will we use it? How will we protect it? We conclude that genome-EMR integration requires a rigorous, multi-faceted and interdisciplinary approach of study. Problems facing the field are numerous, but few are intractable. PMID:26146597

  10. [Nutritional management in amyotrophic lateral sclerosis: A medical and ethical stake].

    PubMed

    Lehéricey, Guillaume; Le Forestier, Nadine; Dupuis, Luc; Gonzalez-Bermejo, Jésus; Meininger, Vincent; Pradat, Pierre-François

    2012-06-01

    Malnutrition and dehydration are common and result from swallowing disorders secondary to degeneration of brainstem motor neurons. Recent knowledge argues in favor of the associated primary metabolism abnormalities. Though muscle atrophy, a paradoxical hypermetabolism at rest has often been observed. Hyperlipidemia and glucose intolerance are more frequent than in general population. The heterogeneity of the nutritional assessment of patients in published series is due, partially at least, to the use of disparate criteria and evaluating procedures. Weight lost is an independent negative survival prognostic factor. Overweight may be beneficial for the survival of ALS patients. A specific nutritional management for ALS is an essential point in the multidisciplinary support. The criteria leading to artificial nutrition indication are medical, mainly based on percentage of weight loss, but also psychological and ethical. PMID:22137288

  11. Ethical and legal implications of elective ventilation and organ transplantation: "medicalization" of dying versus medical mission.

    PubMed

    Frati, Paola; Fineschi, Vittorio; Gulino, Matteo; Montanari Vergallo, Gianluca; Di Luca, Natale Mario; Turillazzi, Emanuela

    2014-01-01

    A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. "Elective ventilation" (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation. PMID:25126582

  12. ESHRE Task Force on ethics and Law 20: sex selection for non-medical reasons.

    PubMed

    Dondorp, W; De Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P; Diedrich, K

    2013-06-01

    This Task Force document revisits the debate about the ethics of sex selection for non-medical reasons in the light of relevant new technological developments. First, as a result of improvement of the Microsort® flow cytometry method, there is now a proven technique for preconception sex selection that can be combined both with IVF and IUI. Secondly, the scenario where new approaches that are currently being developed for preimplantation genetic screening (PGS) may lead to such screening becoming a routine part of all IVF treatment. In that scenario professionals will more often be confronted with parental requests for transfer of an embryo of a specific sex. Thirdly, the recent development of non-invasive prenatal testing based on cell-free fetal DNA in maternal plasma allows for easy and safe sex determination in the early stages of pregnancy. While stressing the new urgency that these developments give to the debate, the Task Force did not come to a unanimous position with regard to the acceptability of sex selection for non-medical reasons in the context of assisted reproduction. Whereas some think maintaining the current ban is the best approach, others are in favour of allowing sex selection for non-medical reasons under conditions that take account of societal concerns about the possible impact of the practice. By presenting these positions, the document reflects the different views about this issue that also exist in the field. Specific recommendations include the need for a wider delineation of accepted 'medical reasons' than in terms of avoiding a serious sex-linked disorder, and for a clarification of the legal position with regard to answering parental requests for 'additional sex selection' in the context of medically indicated preimplantation genetic diagnosis, or routine PGS. PMID:23578946

  13. Ethical and legal issues in palliative care.

    PubMed

    Bernat, J L

    2001-11-01

    This article reviews the ethical principles underlying palliative care, stressing the importance of respecting patient's rights to withdraw or withhold life-sustaining treatment, including artificial hydration and nutrition. There is no ethical or constitutional right to receive physician-assisted suicide or voluntary active euthanasia. This article discusses current ethical controversies in palliative care, including futility, medication dosage and double-effect, terminal sedation, legalization of physician-assisted suicide and euthanasia, and patient refusal of hydration and nutrition. Relevant legal issues are discussed in tandem with the ethical issues. PMID:11854109

  14. [The Ethics and Deontology division of the French National Council of Medical Doctors, eight years of activity, 1993-2001].

    PubMed

    Hoerni, Bernard

    2011-01-01

    The activity of the division of Ethics and deontology of the French National council of medical doctors is analysed by its former president (1993-2001). Among a lot of topics, a new version of the professionnal Code of deontology and patients' information were the main subjects of reflection and action. PMID:22073756

  15. Ethics in the practice of speech-language pathology in health care settings.

    PubMed

    Kummer, Ann W; Turner, Jan

    2011-11-01

    ETHICS refers to a moral philosophy or a set of moral principles that determine appropriate behavior in a society. Medical ethics includes a set of specific values that are considered in determining appropriate conduct in the practice of medicine or health care. Because the practice of medicine and medical speech-language pathology affects the health, well-being, and quality of life of individuals served, adherence to a code of ethical conduct is critically important in the health care environment. When ethical dilemmas arise, consultation with a bioethics committee can be helpful in determining the best course of action. This article will help to define medical ethics and to discuss the six basic values that are commonly considered in discussions of medical ethics. Common ethical mistakes in the practice of speech-language pathology will be described. Finally, the value of a bioethics consultation for help in resolving complex ethical issues will be discussed. PMID:22144083

  16. Who Should Receive Life Support During a Public Health Emergency? Using Ethical Principles to Improve Allocation Decisions

    PubMed Central

    White, Douglas B.; Katz, Mitchell H.; Luce, John M.; Lo, Bernard

    2009-01-01

    A public health emergency such as an influenza pandemic will lead to shortages of mechanical ventilators, critical care beds, and other potentially life saving treatments. This will raise difficult decisions about who will and will not receive these scarce resources. Existing recommendations reflect a narrow utilitarian perspective in which allocation decisions are based primarily on patients' chances of survival to hospital discharge. Certain patient groups, such as the elderly and those with functional impairment, are denied access to potentially life saving treatments based on selective application of additional allocation criteria. We analyze the ethical principles that could guide allocation and propose an allocation strategy that incorporates and balances multiple morally relevant considerations, including saving the most lives, maximizing the number of “life-years” saved, and prioritizing those who have had the least chance to live through life's stages. We also argue that these principles are relevant to all patients and that justice requires that these principles be applied evenly, rather than selectively to the aged, functionally impaired, and those with certain chronic conditions. We discuss strategies to genuinely engage the public in setting the priorities that will guide allocation of scarce life sustaining treatments during a public health emergency. PMID:19153413

  17. Sample size calculations in clinical research should also be based on ethical principles.

    PubMed

    Cesana, Bruno Mario; Antonelli, Paolo

    2016-01-01

    Sample size calculations based on too narrow a width, or with lower and upper confidence limits bounded by fixed cut-off points, not only increase power-based sample sizes to ethically unacceptable levels (thus making research practically unfeasible) but also greatly increase the costs and burdens of clinical trials. We propose an alternative method of combining the power of a statistical test and the probability of obtaining adequate precision (the power of the confidence interval) with an acceptable increase in power-based sample sizes. PMID:26993625

  18. Ethical considerations in burn management.

    PubMed

    Cole, Patrick; Stal, Drew; Hollier, Larry

    2008-07-01

    Catastrophic burn injuries often leave patients in shock or incommunicative, creating complex ethical situations. Patient autonomy and the ability to make competent decisions become key issues. Although patient surrogates may aid in decision making, few patient advocates possess appropriate perspective of burn injury, management options, and likely outcomes. An informed decision requires informed perspective. In addition, debates over futility of care evoke strong emotion. At what point does caring for the severely burned patient become futile, and who defines it as such? Whereas formulas and algorithms guide medical management, very few well-defined principles direct ethical decision making in severe burn management. The physician must rely on his or her understanding of medical ethics to marshal a complex team of burn personnel, maintain institutional protocol, and work closely with patients and patient advocates. Only thorough, thoughtful rational application of ethics can one provide maximal respect for patient autonomy while optimally managing the severe burn injury. PMID:18650707

  19. Medical and Genetic Differences in the Adverse Impact of Sleep Loss on Performance: Ethical Considerations for the Medical Profession

    PubMed Central

    Czeisler, Charles A.

    2009-01-01

    The Institute of Medicine recently concluded that-on average-medical residents make more serious medical errors and have more motor vehicle crashes when they are deprived of sleep. In the interest of public safety, society has required limitations on work hours in many other safety sensitive occupations, including transportation and nuclear power generation. Those who argue in favor of traditional extended duration resident work hours often suggest that there are inter- individual differences in response to acute sleep loss or chronic sleep deprivation, implying that physicians may be more resistant than the average person to the detrimental effects of sleep deprivation on performance, although there is no evidence that physicians are particularly resistant to such effects. Indeed, recent investigations have identified genetic polymorphisms that may convey a relative resistance to the effects of prolonged wakefulness on a subset of the healthy population, although there is no evidence that physicians are over-represented in this cohort. Conversely, there are also genetic polymorphisms, sleep disorders and other inter-individual differences that appear to convey an increased vulnerability to the performance-impairing effects of 24 hours of wakefulness. Given the magnitude of inter-individual differences in the effect of sleep loss on cognitive performance, and the sizeable proportion of the population affected by sleep disorders, hospitals face a number of ethical dilemmas. How should the work hours of physicians be limited to protect patient safety optimally? For example, some have argued that, in contrast to other professions, work schedules that repeatedly induce acute and chronic sleep loss are uniquely essential to the training of physicians. If evidence were to prove this premise to be correct, how should such training be ethically accomplished in the quartile of physicians and surgeons who are most vulnerable to the effects of sleep loss on performance without unacceptably compromising patient safety? Moreover, once it is possible to identify reliably those most vulnerable to the adverse effects of sleep loss on performance, will academic medical centers have an obligation to evaluate the proficiency of both residents and staff physicians under conditions of acute and chronic sleep deprivation? Should work-hour policy limits be modified to ensure that they are not hazardous for the patients of the most vulnerable quartile of physicians, or should the limits be personalized to enable the most resistant quartile to work longer hours? Given that the prevalence of sleep disorders has increased in our society overall, and increases markedly with age, how should fitness for extended duration work hours be monitored over a physician's career? In the spirit of the dictum to do no harm, advances in understanding the medical and genetic basis of inter-individual differences in the performance vulnerability to sleep loss should be incorporated into the development of work-hour policy limits for both physicians and surgeons. PMID:19768182

  20. Practical Divinity and Medical Ethics: Lawful versus Unlawful Medicine in the Writings of William Perkins (1558–1602)

    PubMed Central

    Gevitz, Norman

    2013-01-01

    This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between “lawful” and “unlawful” medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons. PMID:22235029

  1. [Ethical reflection on multidisciplinarity and confidentiality of information in medical imaging through new information and communication technologies].

    PubMed

    Béranger, J; Le Coz, P

    2012-05-01

    Technological advances in medical imaging has resulted in the exponential increase of the number of images per examination, caused the irreversible decline of the silver film and imposed digital imaging. This digitization is a concept whose levels of development are multiple, reflecting the complexity of this process of technological change. Under these conditions, the use of medical information via new information and communication technologies is at the crossroads of several scientific approaches and several disciplines (medicine, ethics, law, economics, psychology, etc.) surrounding the information systems in health, doctor-patient relationship and concepts that are associated. Each day, these new information and communication technologies open up new horizons and the space of possibilities, spectacularly developing access to information and knowledge. In this perspective of digital technology emergence impacting the multidisciplinary use of health information systems, the ethical questions are numerous, especially on the preservation of privacy, confidentiality and security of medical data, and their accessibility and integrity. PMID:22521872

  2. [Withdrawal of artificial nutrition and hydration in severe stroke: medical, legal and ethical considerations].

    PubMed

    Tannier, C; Crozier, S; Zuber, M; Constantinides, Y; Delezie, E; Gisquet, E; Grignoli, N; Lamy, C; Louvet, F; Pinel, J-F

    2015-02-01

    In the majority of cases, severe stroke is accompanied by difficulty in swallowing and an altered state of consciousness requiring artificial nutrition and hydration. Because of their artificial nature, nutrition and hydration are considered by law as treatment rather basic care. Withdrawal of these treatments is dictated by the refusal of unreasonable obstinacy enshrined in law and is justified by the risk of severe disability and very poor quality of life. It is usually the last among other withholding and withdrawal decisions which have already been made during the long course of the disease. Reaching a collegial consensus on a controversial decision such as artificial nutrition and hydration withdrawal is a difficult and complex process. The reluctance for such decisions is mainly due to the symbolic value of food and hydration, to the fear of "dying badly" while suffering from hunger and thirst, and to the difficult distinction between this medical act and euthanasia. The only way to overcome such reluctance is to ensure flawless accompaniment, associating sedation and appropriate comfort care with a clear explanation (with relatives but also caregivers) of the rationale and implications of this type of decision. All teams dealing with this type of situation must have thoroughly thought through the medical, legal and ethical considerations involved in making this difficult decision. PMID:25575609

  3. Medical, legal, and ethical challenges associated with pregnancy and catastrophic brain injury.

    PubMed

    Burkle, Christopher M; Tessmer-Tuck, Jennifer; Wijdicks, Eelco F

    2015-06-01

    In late 2013, two women from North America gained attention after sustaining catastrophic brain injuries while pregnant. After Marlise Muñoz--who was at 14 weeks of pregnancy when she developed a pulmonary embolism--was pronounced brain dead, hospital officials initially refused to withdraw support, citing a Texas state law requiring them to maintain life-sustaining treatment for a pregnant patient to help to save the fetus. By contrast, when Robyn Benson was pronounced brain dead after a brain hemorrhage at 22 weeks of pregnancy, both her husband and the physicians agreed to continue support until a viable child could be delivered. The Muñoz and Benson cases offer an opportunity to explore the medical, legal, and ethical issues surrounding catastrophic brain injury in pregnant women. It is hoped that the present article will enable clinicians to better appreciate the history and present state of issues involving advance directives for pregnant women, maternal versus fetal interests, and the impact of fetal viability on medical decision making, as well as offer a practical assessment of the various US state laws concerning the rare, yet catastrophic event of brain injury in a pregnant woman. PMID:25754143

  4. Psychiatric Residents' Needs for Education about Informed Consent, Principles of Ethics and Professionalism, and Caring for Vulnerable Populations: Results of a Multisite Survey

    ERIC Educational Resources Information Center

    Jain, Shaili; Lapid, Maria I.; Dunn, Laura B.; Roberts, Laura Weiss

    2011-01-01

    Objective: The authors examined psychiatric residents' perceived needs for education in informed consent, principles of ethics and professionalism, and treating vulnerable populations. Method: A written survey was distributed to psychiatric residents (N = 249) at seven U.S. residency programs in 2005. The survey contained 149 questions in 10…

  5. Justice and welfare: two ethical paradigms in forensic psychiatry.

    PubMed

    Adshead, Gwen; Sarkar, Sameer P

    2005-01-01

    Forensic psychiatry, as a medical specialty, perhaps understandably leans toward beneficence or welfare as its main ethical underpinning. However, the special nature of the art or science of forensic psychiatry makes it imperative that beneficence is not the only ethical principle that guides the 'good' forensic psychiatrist. Indeed, the commonest ethical dilemmas in forensic psychiatry arise from a conflict between two ethical principles: beneficence, or promotion of welfare, and respect for justice. These two paradigms dominate discussions about the moral role and ethical duties of forensic psychiatrists and, in effect, give rise to two different practices in forensic psychiatry, each of which can also be said to have acquired a national identity. We discuss these competing principles and offer some thoughts about what this means for the ethics and values of forensic psychiatry. PMID:16343303

  6. Knowledge and practice of clinical ethics among healthcare providers in a government hospital, Chennai.

    PubMed

    Subramanian, Thilakavathi; Mathai, A K; Kumar, Nandini

    2013-01-01

    The growing public concern about the ethical conduct of healthcare professionals highlights the need to incorporate clinical ethics in medical education. This study examined the knowledge and practice of clinical ethics among healthcare providers in a government hospital in Chennai. A sample of 51 treating physicians and 58 other non-physician service providers from the hospital answered a self-administered, semi-structured questionnaire on their knowledge of and adherence to ethical principles, and the problems they faced related to healthcare ethics. More than 30% did not give a definition of healthcare ethics, and 40% did not name a single ethical principle. 51% stated that they witnessed ethical problems in their settings and named patient dissatisfaction, gender bias by provider, and not maintaining confidentiality. The responses of healthcare providers to various ethical scenarios are reported. PMID:23697487

  7. Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

    PubMed Central

    2010-01-01

    Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy. PMID:20082703

  8. Access to Medical Records.

    ERIC Educational Resources Information Center

    Cooper, Nancy

    Although confidentiality with regard to medical records is supposedly protected by the American Medical Associaton's principles of Ethics and the physician-patient privilege, there are a number of laws that require a physician to release patient information to public authorities without the patient's consent. These exceptions include birth and…

  9. Psychiatric ethics in war and peace

    PubMed Central

    Raju, M. S. V. K.

    2013-01-01

    Practice of psychiatry is a complex activity because the psychiatrist generally practises his art in an emotionally charged environment with patients who may not be in a in a state of mind to exercise autonomy as a result of cognitive impairment and preoccupation with symptoms. No one principle of ethics will be suitable to guide right conduct in widely variable situations. Making ethical judgements in the military context can be difficult and may have potential for abuse as for an uniformed psychiatrist mission takes priority over man. However mission centered and medical text book centred ethics need not be compartamentalised. The present paper seeks to offer a brief overview of ethical principles and specific situations in which one may have to make ethical judgements. PMID:24459379

  10. 015. Ethical dilemmas, medical protocols and deontology in diagnosis of lung cancer during pregnancy

    PubMed Central

    Manos, Emmanouil; Gkika, Dimitra; Euthimiou, Christoforos; Lola, Vassiliki; Potonos, Stefanos; Kokkori, Ioanna; Tsiouda, Theodora; Pililitsis, Leonidas; Angel, Jacob

    2015-01-01

    Background Lung cancer is second in frequency in both sexes, with very poor prognosis and high mortality rates. Smoking is the main cause. Malignant neoplasms of the lung on pregnancy are not very frequent. They constitute a direct threat for the woman’s life and simultaneously the outcome of pregnancy is doubtful. Objective We present this case because of the rarity of coexistence of lung neoplasm and pregnancy, in absence of treatment guidelines. The question of overcoming, by the attending physician, the ethical dilemmas and the medical protocols is apposed, in the progress and outcome of pregnancy, when lung malignant neoplasm coexists. Methods A 33-year-old woman, smoker, with occasional alcohol consumption and medical history of Leiden thrombophilia, is at 18-19 weeks of gestation. She presents to the emergency department of the general hospital with reported episodes of dyspnea and cough. She refers cough with difficulty in the elimination of sputum, dyspnea, orthopnea, facial and neck edema with venous distension, common symptoms of superior vena cava syndrome. The CT scan revealed a lung mass in the right upper lobe with the right hilum involved. The rest of the staging was negative. Results The first bronchoscopy revealed edema in the main carina and right upper lobe stenosis while the biopsy samples did not demonstrate a histological identification. Mediastinoscopy was followed and revealed a poorly differentiated carcinoma (primary pulmonary neuroendocrine tumor). Both patient and relatives consented to start chemotherapy treatment. After four cycles of chemotherapy with carboplatin + etoposide, the patient in the 7th month of gestation, gave birth to a healthy baby boy weighted 1,130 gr. The patient died after four months because she suffered from an extremely aggressive tumor with brain and diffused spinal metastatic infiltrations and also from the appearance of paraneoplastic disorders like Lambert-Eaton myasthenic syndrome. Conclusions The successful outcome of pregnancy with coexisting malignant lung neoplasm is an achievable target, even though seems rather impossible. It is required a conscious overcoming, not only of the lack of existing treatment guidelines but also by the involving of the ethical dilemmas that may arise.

  11. The ethics of limiting informed debate: censorship of select medical publications in the interest of organ transplantation.

    PubMed

    Potts, Michael; Verheijde, Joseph L; Rady, Mohamed Y; Evans, David W

    2013-12-01

    Recently, several articles in the scholarly literature on medical ethics proclaim the need for "responsible scholarship" in the debate over the proper criteria for death, in which "responsible scholarship" is defined in terms of support for current neurological criteria for death. In a recent article, James M. DuBois is concerned that academic critiques of current death criteria create unnecessary doubt about the moral acceptability of organ donation, which may affect the public's willingness to donate. Thus he calls for a closing of the debate on current death criteria and for journal editors to publish only critiques that "substantially engage and advance the debate." We argue that such positions as DuBois' are a threat to responsible scholarship in medical ethics, especially scholarship that opposes popular stances, because it erodes academic freedom and the necessity of debate on an issue that is literally a matter of life and death, no matter what side a person defends. PMID:24225389

  12. The pitfalls of deducing ethics from behavioral economics: why the Association of American Medical Colleges is wrong about pharmaceutical detailing.

    PubMed

    Huddle, Thomas S

    2010-01-01

    The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so is a prudential judgment about which reasonable people may disagree. The AAMC's ethical condemnation of detailing is unwarranted and will subvert efforts to maintain a realm of physician discretion in clinical work that is increasingly threatened in our present practice environment. PMID:20077321

  13. Medical ethics in the wake of the Holocaust: departing from a postwar paper by Ludwik Fleck.

    PubMed

    Hedfors, Eva

    2007-09-01

    In 1948 Ludwik Fleck published a paper in Polish discussing the use of humans in medical experiments, thereby addressing his peers. Though the paper has so far not been translated or studied, it has been taken to indicate Fleck's deep commitment to ethical questions, notably the question of informed consent. In being written by a former victim of the Nazi policy and a survivor of the Holocaust also acting as an expert witness in the trial of the IG Farben in Nuremberg, the paper is of interest. A scrutiny of Fleck's text and related sources discloses, however, not only the complexity of the issue at the centre of the Nuremberg trial, but also Fleck's unexpected stance in seemingly adducing his arguments from both the German defendants and the prosecution, heavily informed by US scientists. Further, the contentious discussion of the past in Fleck's paper reveals its links to modern bioethical discussion. Though sometimes oblivious of that past, it still faces the same questions. PMID:17893071

  14. René Leriche and “Philosophy of Surgery” in the light of contemporary medical ethics

    PubMed Central

    Akça, Tamer; Ayd?n, Süha

    2013-01-01

    Prof. Dr. René Leriche was a famous French surgeon who lived between 1879 and 1955. After working as a vascular surgeon in Lyon, he was appointed professor at the University of Strasbourg in 1924 and later the Paris Collége de France in 1937. Leriche had proposed vascular patches as the ideal treatment for obliterated vascular segments and advocated the necessity of sympathectomy in arterial diseases in the 1920s. He defined “Leriche Syndrome” in 1923 which is known by his name and which develops as a result of incomplete obstruction of the aortic bifurcation. René Leriche wrote a monograph entitled “La Chirurgie de la Douleur-Pain Surgery” in 1940 and he also became a pioneer in the sympathectomy procedure for pain treatment. René Leriche focused on topics that must be remembered again today, including surgery advanced into science, the physiological basis of surgery, research methods, as well as issues such as business technology, humanity in surgery, surgical essence and surgeon’s qualifications in the book entitled “La Philosophie de la Chirurgie-Philosophy of Surgery” that he wrote in 1951. In this review, the issues that Prof. Dr. René Leriche addressed in middle of the 20th century were revised in the light of contemporary medical ethics. PMID:25931863

  15. [Elucidation of compatibility principle and scientific value of Chinese medical formulae based on pharmacometabolomics].

    PubMed

    Wang, Xijun; Zhang, Boli

    2010-05-01

    By using UPLC coupled with MS, the analysis of the constituents absorbed into blood after oral administration of Yinchenhao decotion with different combination had been carried out, the body fate of constituents detected in the blood was elucidated also; At the same time, the overall body respones after multi-input of the medical formule were evaluated by metabolomic analysis. These data explained the scientific values in both drug metabolisim and metabonomics, the results had given some new evidences for the potentialities of pharmacometabonomics to elucidate the compatibility principle of Chinese medical formule. As a conclusion, concept of "Pharmacometabolomics of Chinmediformulae" has been defined. PMID:20707212

  16. Secondary use of empirical research data in medical ethics papers on gamete donation: forms of use and pitfalls.

    PubMed

    Provoost, Veerle

    2015-03-01

    This paper aims to provide a description of how authors publishing in medical ethics journals have made use of empirical research data in papers on the topic of gamete or embryo donation by means of references to studies conducted by others (secondary use). Rather than making a direct contribution to the theoretical methodological literature about the role empirical research data could play or should play in ethics studies, the focus is on the particular uses of these data and the problems that can be encountered with this use. In the selection of papers examined, apart from being used to describe the context, empirical evidence was mainly used to recount problems that needed solving. Few of the authors looked critically at the quality of the studies they quoted, and several instances were found of empirical data being used poorly or inappropriately. This study provides some initial baseline evidence that shows empirical data, in the form of references to studies, are sometimes being used in inappropriate ways. This suggests that medical ethicists should be more concerned about the quality of the empirical data selected, the appropriateness of the choice for a particular type of data (from a particular type of study) and the correct integration of this evidence in sound argumentation. Given that empirical data can be misused also when merely cited instead of reported, it may be worthwhile to explore good practice requirements for this type of use of empirical data in medical ethics. PMID:25835327

  17. TEACHING PHYSICS: An experiment to demonstrate the principles and processes involved in medical Doppler ultrasound

    NASA Astrophysics Data System (ADS)

    Andrews, D. G. H.

    2000-09-01

    Doppler ultrasound is widely used in medicine for measuring blood velocity. This paper describes an experiment illustrating the principles of medical Doppler ultrasound. It is designed with A-level/undergraduate physics students in mind. Ultrasound is transmitted in air and reflected from a moving target. The return signal is processed using a series of modules, so that students can discover for themselves how each stage in the instrument works. They can also obtain a quantitative value of the speed of the target.

  18. [The biologization of ethics].

    PubMed

    Moreno Lax, Alejandro

    2010-01-01

    Three ethics exist as a condition of possibility of any possible ethics, following a material and biological foundation. This content argument (not logical-formal) supposes a refutation of the naturalistic fallacy that the analytical philosophy attributes to Hume, in three areas of the ethical human experience: body, society and nature. These are: the ethics of the species [J. Habermas], the ethics of liberation [E. Dussel] and the ethics of the responsibility [H. Jonas]. This material argument is a philosophical foundation to considering for three types of applied ethics: medical bioethics, development ethics and environmental ethics. PMID:20405971

  19. Ethical issues in medical-sequencing research: implications of genotype-phenotype studies for individuals and populations.

    PubMed

    Foster, Morris W; Sharp, Richard R

    2006-04-15

    Advances and declining costs in sequencing technology will result in increasing number of studies with individual sequence data linked to phenotypic information, which has been dubbed medical sequencing. At least some of this linked information will be publicly available. Medical sequencing raises ethical issues for both individuals and populations, including data release and identifiability, adequacy of consent, reporting research results, stereotyping and stigmatization, inclusion and differential benefit and culturally and community-specific concerns. Those issues are reviewed, along with possible solutions to them. PMID:16651368

  20. [Research ethics committees: a necessary good].

    PubMed

    Riera, Alejandra V

    2013-12-01

    The Nuremberg Code, issued as the result of the deliberations of the Nuremberg Trials, which judged the atrocities carried out during Nazi Germany (1933-1945), was the first universal document that defined research ethics principles for human experimentation. This code served as the basis for the subsequent ethical codes and principles used today by the Research Ethics Committees. The Research Ethics Committee is a multidisciplinary body whose primary role is to protect the rights and welfare of research subjects through the review of research protocols, ensuring compliance with internationally and locally accepted ethical guidelines. Worldwide, there have been important improvements in order to promote and regulate bioethics in medical research. In Venezuela, several national organizations have been constituted with the aim of promoting the establishment of ethics committees; however, there has not been a significant progress in the quantity or quality of the functioning of Research Ethics Committees in the country. It is imperative for each research institution to establish and work to improve their ethics committee to ensure the quality of the clinical research conducted, making it adherent to ethical codes, and safeguarding the integrity and credibility of the investigators and the research institutions, and more importantly, the patient's rights. PMID:24502176

  1. Disagreements with implications: diverging discourses on the ethics of non-medical use of methylphenidate for performance enhancement

    PubMed Central

    Forlini, Cynthia; Racine, Eric

    2009-01-01

    Background There is substantial evidence that methylphenidate (MPH; Ritalin), is being used by healthy university students for non-medical motives such as the improvement of concentration, alertness, and academic performance. The scope and potential consequences of the non-medical use of MPH upon healthcare and society bring about many points of view. Methods To gain insight into key ethical and social issues on the non-medical use of MPH, we examined discourses in the print media, bioethics literature, and public health literature. Results Our study identified three diverging paradigms with varying perspectives on the nature of performance enhancement. The beneficial effects of MPH on normal cognition were generally portrayed enthusiastically in the print media and bioethics discourses but supported by scant information on associated risks. Overall, we found a variety of perspectives regarding ethical, legal and social issues related to the non-medical use of MPH for performance enhancement and its impact upon social practices and institutions. The exception to this was public health discourse which took a strong stance against the non-medical use of MPH typically viewed as a form of prescription abuse or misuse. Wide-ranging recommendations for prevention of further non-medical use of MPH included legislation and increased public education. Conclusion Some positive portrayals of the non-medical use of MPH for performance enhancement in the print media and bioethics discourses could entice further uses. Medicine and society need to prepare for more prevalent non-medical uses of neuropharmaceuticals by fostering better informed public debates. PMID:19580661

  2. The ethics of complex relationships in primary care behavioral health.

    PubMed

    Reiter, Jeff; Runyan, Christine

    2013-03-01

    Primary care settings are particularly prone to complex relationships that can be ethically challenging. This is due in part to three of the distinctive attributes of primary care: a whole family orientation; team-based care; and a longitudinal care delivery model. In addition, the high patient volume of primary care means that the likelihood of encountering ethically challenging relationships is probably greater than in a specialty setting. This article argues that one ethical standard of the American Psychological Association (APA, 2010, Ethical principles of psychologists and code of conduct, www.apa.org/ethics/code) (10.02, Therapy Involving Couples or Families) should be revised to better accommodate the work of psychologists in primary care. The corresponding Principles of Medical Ethics from the American Medical Association (AMA, 2012, Code of medical ethics: Current opinions with annotations, 2012-2013, Washington, DC: Author), most notably the principle regarding a physician's duty to "respect the rights of patients, colleagues, and other health professionals as well as safeguard privacy" are also noted. In addition, the article details how the three attributes of primary care often result in complex relationships, and provides suggestions for handling such relationships ethically. PMID:23566124

  3. Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

    PubMed Central

    Hilberman, M; Kutner, J; Parsons, D; Murphy, D J

    1997-01-01

    Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated. PMID:9451605

  4. Ethics education.

    PubMed

    Dingle, Arden D; Stuber, Margaret L

    2008-01-01

    This article briefly describes the background and status of medical education in the areas of ethics and professionalism. Methods of teaching and assessment are described for medical students, residents, and practitioners within the core competency framework of medical education. Key areas of content for child and adolescent psychiatrists are described. PMID:18036486

  5. Medical database security policies.

    PubMed

    Pangalos, G J

    1993-11-01

    Database security plays an important role in the overall security of medical information systems. Security does not only involve fundamental ethical principles such as privacy and confidentiality, but is also an essential prerequisite for effective medical care. The general framework and the requirements for medical database security are presented. The three prominent proposals for medical database security are discussed in some detail, together with specific proposals for medical database security. A number of parameters for a secure medical database development are presented and discussed, and guidelines are given for the development of secure medical database systems. PMID:8295541

  6. Views of Ethical Best Practices in Sharing Individual-Level Data From Medical and Public Health Research

    PubMed Central

    Roberts, Nia; Parker, Michael

    2015-01-01

    There is increasing support for sharing individual-level data generated by medical and public health research. This scoping review of empirical research and conceptual literature examined stakeholders’ perspectives of ethical best practices in data sharing, particularly in low- and middle-income settings. Sixty-nine empirical and conceptual articles were reviewed, of which, only five were empirical studies and eight were conceptual articles focusing on low- and middle-income settings. We conclude that support for sharing individual-level data is contingent on the development and implementation of international and local policies and processes to support ethical best practices. Further conceptual and empirical research is needed to ensure data sharing policies and processes in low- and middle-income settings are appropriately informed by stakeholders’ perspectives. PMID:26297745

  7. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems

    PubMed Central

    Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design. PMID:20819851

  8. Problems for clinical judgement: 5. Principles of influence in medical practice

    PubMed Central

    Redelmeier, Donald A.; Cialdini, Robert B.

    2002-01-01

    THE BASIC SCIENCE OF PSYCHOLOGY HAS IDENTIFIED specific ingrained responses that are fundamental elements of human nature, underpin common influence strategies and may apply in medical settings. People feel a sense of obligation to repay a perceived debt. A request becomes more attractive when preceded by a marginally worse request. The drive to act consistently will persist even if demands escalate. Peer pressure is intense when people face uncertainty. The image of the requester influences the attractiveness of a request. Authorities have power beyond their expertise. Opportunities appear more valuable when they appear less available. These 7 responses were discovered decades ago in psychology research and seem intuitively understood in the business world, but they are rarely discussed in medical texts. An awareness of these principles can provide a framework for physicians to help patients change their behaviour and to understand how others in society sometime alter patients' choices. PMID:12126325

  9. State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine

    PubMed Central

    Schochow, Maximilian; Steger, Florian

    2015-01-01

    Background: Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Methods: Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Results: Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. Conclusions: This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning. PMID:26038682

  10. Principles for new optical techniques in medical diagnostics for mHealth applications

    NASA Astrophysics Data System (ADS)

    Balsam, Joshua Michael

    Medical diagnostics is a critical element of effective medical treatment. However, many modern and emerging diagnostic technologies are not affordable or compatible with the needs and conditions found in low-income and middle-income countries and regions. Resource-poor areas require low-cost, robust, easy-to-use, and portable diagnostics devices compatible with telemedicine (i.e. mHealth) that can be adapted to meet diverse medical needs. Many suitable devices will need to be based on optical technologies, which are used for many types of biological analyses. This dissertation describes the fabrication and detection principles for several low-cost optical technologies for mHealth applications including: (1) a webcam based multi-wavelength fluorescence plate reader, (2) a lens-free optical detector used for the detection of Botulinum A neurotoxin activity, (3) a low cost micro-array reader that allows the performance of typical fluorescence based assays demonstrated for the detection of the toxin staphylococcal enterotoxin (SEB), and (4) a wide-field flow cytometer for high throughput detection of fluorescently labeled rare cells. This dissertation discusses how these technologies can be harnessed using readily available consumer electronics components such as webcams, cell phones, CCD cameras, LEDs, and laser diodes. There are challenges in developing devices with sufficient sensitivity and specificity, and approaches are presented to overcoming these challenges to create optical detectors that can serve as low cost medical diagnostics in resource-poor settings for mHealth.

  11. The politics and strategy of industry self-regulation: the pharmaceutical industry's principles for ethical direct-to-consumer advertising as a deceptive blocking strategy.

    PubMed

    Arnold, Denis G; Oakley, James L

    2013-06-01

    As the pharmaceutical industry lobbies European regulators to permit direct-to-consumer advertising (DTCA) of prescription drugs in the European Union, we found that five leading companies violated industry-developed and -promulgated standards for ethical advertising in the United States. Utilizing multiple data sources and methods, we demonstrate a consistent failure by companies that market erectile dysfunction drugs to comply with the industry's guiding principles for ethical DTCA over a four-year period despite pledges of compliance by company leaders. Noncompliance resulted in children being exposed to sexually themed promotional messages more than 100 billion times. We argue that the guidelines are a coordinated effort by the industry to prevent unwanted federal regulation, and we introduce the concept of a blocking strategy to explain company behavior and to advance theoretical understanding of firms' public affairs strategies. We recommend policy responses to prevent deceptive practices, protect children from adult content, and promote genuine health care education. PMID:23418365

  12. Aequilibrium prudentis: on the necessity for ethics and policy studies in the scientific and technological education of medical professionals

    PubMed Central

    2013-01-01

    Background The importance of strong science, technology, engineering, and mathematics education continues to grow as society, medicine, and the economy become increasingly focused and dependent upon bioscientific and technological innovation. New advances in frontier sciences (e.g., genetics, neuroscience, bio-engineering, nanoscience, cyberscience) generate ethical issues and questions regarding the use of novel technologies in medicine and public life. Discussion In light of current emphasis upon science, technology, engineering, and mathematics education (at the pre-collegiate, undergraduate, graduate, and professional levels), the pace and extent of advancements in science and biotechnology, the increasingly technological orientation and capabilities of medicine, and the ways that medicine – as profession and practice – can engage such scientific and technological power upon the multi-cultural world-stage to affect the human predicament, human condition, and perhaps nature of the human being, we argue that it is critical that science, technology, engineering, and mathematics education go beyond technical understanding and directly address ethical, legal, social, and public policy implications of new innovations. Toward this end, we propose a paradigm of integrative science, technology, ethics, and policy studies that meets these needs through early and continued educational exposure that expands extant curricula of science, technology, engineering, and mathematics programs from the high school through collegiate, graduate, medical, and post-graduate medical education. We posit a synthetic approach that elucidates the historical, current, and potential interaction of scientific and biotechnological development in addition to the ethico-legal and social issues that are important to educate and sustain the next generation of medical and biomedical professionals who can appreciate, articulate, and address the realities of scientific and biotechnological progress given the shifting architectonics of the global social milieu. Summary We assert that current trends in science, technology, medicine, and global politics dictate that these skills will be necessary to responsibly guide ethically sound employment of science, technology, and engineering advancements in medicine so as to enable more competent and humanitarian practice within an increasingly pluralistic world culture. PMID:23617840

  13. Solutions to Infertility: Even the Simplest Medical Answer Raises Troubling Ethical Questions for Catholics.

    ERIC Educational Resources Information Center

    Boyle, Philip

    1989-01-01

    Considers the ethical issues surrounding the "simplest" case of in vitro fertilization from the author's interpretation of a Catholic perspective. Discusses serious moral objections to in vitro fertilization voiced by the Vatican, and presents theological reasons why Catholics should question in vitro fertilization. (Author/NB)

  14. Medical, health-science students bring different perspectives to interdisciplinary ethics course

    PubMed Central

    Kent, H

    1997-01-01

    The University of British Columbia offers a unique health care ethics course to students in 12 disciplines, including medicine. Organizers say the course addresses the "traditional separatism" in health-sciences teaching that for too long has been characterized by a lack of interdisciplinary collaboration. PMID:9145061

  15. The Human Rights Context for Ethical Requirements for Involving People with Intellectual Disability in Medical Research

    ERIC Educational Resources Information Center

    Iacono, T.; Carling-Jenkins, R.

    2012-01-01

    Background: The history of ethical guidelines addresses protection of human rights in the face of violations. Examples of such violations in research involving people with intellectual disabilities (ID) abound. We explore this history in an effort to understand the apparently stringent criteria for the inclusion of people with ID in research, and…

  16. Predictors of Physician Recommendation for Ethically Controversial Medical Procedures: Findings from an Exploratory National Survey of American Muslim Physicians.

    PubMed

    Mahdi, Sundus; Ghannam, Obadah; Watson, Sydeaka; Padela, Aasim I

    2016-04-01

    Physician religiosity can influence their ethical attitude toward medical procedures and can thereby impact healthcare delivery. Using a national survey of American Muslim physicians, we explored the association between physician recommendation of three controversial medical procedures-tubal ligation, abortion, and porcine-based vaccine-and their (1) religiosity, (2) utilization of bioethics resources, and (3) perception of whether the procedure was a medical necessity and if the scenario represented a life threat. Generally, multivariate models found that physicians who read the Qur'an more often as well as those who perceived medical necessity and/or life threat had a higher odds recommending the procedures, whereas those who sought Islamic bioethical guidance from Islamic jurists (or juridical councils) more often had a lower odds. These associations suggest that the bioethical framework of Muslim physicians is influenced by their reading of scripture, and the opinions of Islamic jurists and that these influences may, paradoxically, be interpreted to be in opposition over some medical procedures. PMID:26613589

  17. The impact of an interprofessional problem-based learning curriculum of clinical ethics on medical and nursing students' attitudes and ability of interprofessional collaboration: a pilot study.

    PubMed

    Lin, Yu-Chih; Chan, Te-Fu; Lai, Chung-Sheng; Chin, Chi-Chun; Chou, Fan-Hao; Lin, Hui-Ju

    2013-09-01

    Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group). Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach ?, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA) test and Tukey-Kramer honestly significant difference (HSD) comparison. There was significant difference among different groups in students' ability and attitudes about "interprofessional communication and collaboration" (p = 0.0184). The scores in the mixed group (37.58 ± 3.26) were higher than the medical group (32.10 ± 4.98). In conclusion, our model for the interprofessional PBL curriculum of clinical ethics is practicable and will produce positive impacts on students' attitudes and confidence of interprofessional collaboration. PMID:24018155

  18. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years. PMID:18209830

  19. Ethics for Fundraisers.

    ERIC Educational Resources Information Center

    Anderson, Albert

    Intended for professionals and others in the field of philanthropy, this book applies ethics and ethical decision-making to fund raising. Its primary aim is to enhance the level of ethical fund raising throughout the nonprofit sector by equipping those involved with frameworks for understanding and taking principled actions and preventing…

  20. Ethics for Fundraisers.

    ERIC Educational Resources Information Center

    Anderson, Albert

    Intended for professionals and others in the field of philanthropy, this book applies ethics and ethical decision-making to fund raising. Its primary aim is to enhance the level of ethical fund raising throughout the nonprofit sector by equipping those involved with frameworks for understanding and taking principled actions and preventing…

  1. Health sciences librarians' awareness and assessment of the Medical Library Association Code of Ethics for Health Sciences Librarianship: the results of a membership survey

    PubMed Central

    Byrd, Gary D.; Devine, Patricia J.; Corcoran, Kate E.

    2014-01-01

    Objective: The Medical Library Association (MLA) Board of Directors and president charged an Ethical Awareness Task Force and recommended a survey to determine MLA members' awareness of and opinions about the current Code of Ethics for Health Sciences Librarianship. Methods: The task force and MLA staff crafted a survey to determine: (1) awareness of the MLA code and its provisions, (2) use of the MLA code to resolve professional ethical issues, (3) consultation of other ethical codes or guides, (4) views regarding the relative importance of the eleven MLA code statements, (5) challenges experienced in following any MLA code provisions, and (6) ethical problems not clearly addressed by the code. Results: Over 500 members responded (similar to previous MLA surveys), and while most were aware of the code, over 30% could not remember when they had last read or thought about it, and nearly half had also referred to other codes or guidelines. The large majority thought that: (1) all code statements were equally important, (2) none were particularly difficult or challenging to follow, and (3) the code covered every ethical challenge encountered in their professional work. Implications: Comments provided by respondents who disagreed with the majority views suggest that the MLA code could usefully include a supplementary guide with practical advice on how to reason through a number of ethically challenging situations that are typically encountered by health sciences librarians. PMID:25349544

  2. Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

    PubMed

    McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

    2015-09-01

    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being. PMID:26133890

  3. To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya.

    PubMed

    House, Darlene R; Marete, Irene; Meslin, Eric M

    2016-01-01

    While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured. PMID:26474601

  4. To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya

    PubMed Central

    House, Darlene R; Marete, Irene; Meslin, Eric M

    2016-01-01

    While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured. PMID:26474601

  5. Principles and practice of hyperbaric medicine: a medical practitioner's primer, part II.

    PubMed

    Perdrizet, George A

    2014-08-01

    Advances in the treatment of chronic wounds* have steadily occurred over the past decade and include the specialized use of dynamic compression therapy, implementation of moist wound care techniques, chronic lymphedema therapy, negative pressure wound therapy, arterial compression therapy and application of off-loading devices. General medical practitioners should recognize when timely patient referral to a comprehensive wound care center is indicated. The clinical practice of HBOT and its scientific basis has also advanced significantly during this same time period. HBOT is a therapeutic tool with many qualities that are unique to medical care and enable difficult and otherwise untreatable conditions to be safely and effectively managed. Level 1 evidence exists for HBOT and the therapeutic indications are growing. It is the responsibility of all practitioners to become informed about the modern principles and practice of HBOT. Clinicians should take the advice of Mark Twain: "Supposing is good but finding out is better." It is the responsibility of educational institutions and medical societies to become informed and actively engaged in hyperbaric medical care, education and research. This will benefit our patients as well as our systems of medical care. There is now ample access to hyperbaric oxygen facilities and expertise with the state. There is a growing need for HBOT services due to the rising incidence of obesity and diabetes combined with an aging demographic. Appropriate networks and patterns of referral have lagged behind this demand due to a generalized lack of understanding of the true risks, benefits and indications for HBOT. This review will hopefully begin to address this problem. Hyperbaric medicine is in an early phase of development. The current and future demand for clinical services will drive development of research and educational programs. Only through continued efforts for perform high quality research and education will the full potential of HBOT be realized. Much remains to be done. As systems for the delivery of healthcare enter an era of population management, the regenerative potential of hyperbaric therapies should improve quality of and reduce costs and enable us to meet the challenge of providing care for the growing population of chronic wound patients. PMID:25195304

  6. Towards clinical bioethics (or a return to clinical ethics?).

    PubMed

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  7. Health research ethics review and needs of institutional ethics committees in Tanzania.

    PubMed

    Ikingura, J K B; Kruger, M; Zeleke, W

    2007-09-01

    This study was undertaken to describe the performance of health research ethics review procedures of six research centres in Tanzania. Data collection was done through a self-administered questionnaire and personal interviews. The results showed that there were on average 11 members (range = 8-14) in each Research Ethic Committee. However, female representation in the committees was low (15.2%). The largest proportion of the committee members was biomedical scientists (51.5%). Others included medical doctors (19.7%), social scientists (7.6%), laboratory technologists (10.6%), religious leaders (4.5%), statisticians (3.0%), teachers (1.5%) and lawyers (1.5). Committee members had different capacities to carry out review of research proposals (no capacity = 2%; limited capacity = 15%; moderate capacity = 20%; good capacity = 48%, excellent capacity = 13%). Only half of the respondents had prior ethics review training. Although the majority deemed that ethical guidelines were very important (66%), there were challenges in the use of ethical guidelines which included lack of awareness on the national accreditation mechanisms for ethics committee (59%). Adherence to ethical principles and regulations was influenced by being a scientist (OR = 42.47), being an employee of a professional organization (OR = 15.25), and having an interests in the use of ethical guidelines (OR = 10.85) These findings indicate the need for capacity strengthening (through training and resource support), inclusion of more female representation and other mandatory professions to the research ethics committees. PMID:18087891

  8. A history of ethics and law in the intensive care unit.

    PubMed

    Luce, John M; White, Douglas B

    2009-01-01

    Because they provide potential benefit at great personal and public cost, the intensive care unit (ICU) and the interventions rendered therein have become symbols of both the promise and the limitations of medical technology. At the same time, the ICU has served as an arena in which many of the ethical and legal dilemmas created by that technology have been defined and debated. This article outlines major events in the history of ethics and law in the ICU, covering the evolution of ICUs, ethical principles, informed consent and the law, medical decision-making, cardiopulmonary resuscitation, withholding and withdrawing life-sustaining therapy, legal cases involving life support, advance directives, prognostication, and futility and the allocation of medical resources. Advancement of the ethical principle of respect for patient autonomy in ICUs increasingly is in conflict with physicians' concern about their own prerogatives and with the just distribution of medical resources. PMID:19268804

  9. Excellence, Sharing, and Solidarity as Ethical Principles for International Academic Co-operation: The "Agence universitaire de la Francophonie"

    ERIC Educational Resources Information Center

    Maniere, Roger

    2004-01-01

    In this article the author addresses some of the ethical and moral challenges embodied in the global era. He considers the case of European universities and their heritage, particularly in light of the massification of West European, and now East and Central European, higher education systems. It is argued that European integration rests on…

  10. Ethical Principles Associated with the Publication of Research in ASHA's Scholarly Journals: Importance and Adequacy of Coverage

    ERIC Educational Resources Information Center

    Ingham, Janis C.; Minifie, Fred D.; Horner, Jennifer; Robey, Randall R.; Lansing, Charissa; McCartney, James H.; Slater, Sarah C.; Moss, Sharon E.

    2011-01-01

    Purpose: The purpose of this 2-part study was to determine the importance of specific topics relating to publication ethics and adequacy of the American Speech-Language-Hearing Association's (ASHA's) policies regarding these topics. Method: A 56-item Web-based survey was sent to (a) ASHA journal editors, associate editors, and members of the…

  11. Ethical Principles Associated with the Publication of Research in ASHA's Scholarly Journals: Importance and Adequacy of Coverage

    ERIC Educational Resources Information Center

    Ingham, Janis C.; Minifie, Fred D.; Horner, Jennifer; Robey, Randall R.; Lansing, Charissa; McCartney, James H.; Slater, Sarah C.; Moss, Sharon E.

    2011-01-01

    Purpose: The purpose of this 2-part study was to determine the importance of specific topics relating to publication ethics and adequacy of the American Speech-Language-Hearing Association's (ASHA's) policies regarding these topics. Method: A 56-item Web-based survey was sent to (a) ASHA journal editors, associate editors, and members of the…

  12. Teaching the Ethics of Biology.

    ERIC Educational Resources Information Center

    Johansen, Carol K.; Harris, David E.

    2000-01-01

    Points out the challenges of educating students about bioethics and the limited training of many biologists on ethics. Discusses the basic principles of ethics and ethical decision making as applied to biology. Explains the models of ethical decision making that are often difficult for students to determine where to begin analyzing. (Contains 28…

  13. Teaching the Ethics of Biology.

    ERIC Educational Resources Information Center

    Johansen, Carol K.; Harris, David E.

    2000-01-01

    Points out the challenges of educating students about bioethics and the limited training of many biologists on ethics. Discusses the basic principles of ethics and ethical decision making as applied to biology. Explains the models of ethical decision making that are often difficult for students to determine where to begin analyzing. (Contains 28…

  14. ESHRE Task Force on Ethics and Law 23: medically assisted reproduction in singles, lesbian and gay couples, and transsexual people†.

    PubMed

    De Wert, G; Dondorp, W; Shenfield, F; Barri, P; Devroey, P; Diedrich, K; Tarlatzis, B; Provoost, V; Pennings, G

    2014-09-01

    This Task Force document discusses ethical issues arising with requests for medically assisted reproduction from people in what may be called 'non-standard' situations and relationships. The document stresses that categorically denying access to any of these groups cannot be reconciled with a human rights perspective. If there are concerns about the implications of assisted reproduction on the wellbeing of any of the persons involved, including the future child, a surrogate mother or the applicants themselves, these concerns have to be considered in the light of the available scientific evidence. When doing so it is important to avoid the use of double standards. More research is needed into the psychosocial implications of raising children in non-standard situations, especially with regard to single women, male homosexual couples and transsexual people. PMID:25052011

  15. Rehabilitation in a rural setting of a young quadriplegic accident victim. Integrative clinicopathological conference: medical, psychosocial, economic, preventive, and ethical dimensions of a case study.

    PubMed Central

    Lewis, B. R.; Flanigan, R. C.; Blomquist, G. C.; Tempkin, A. R.; Fuhrer, M. J.; Thompson, J. S.; Engelberg, J.

    1985-01-01

    Problems encountered by a young, unmarried woman who, as a result of a spinal injury in an automobile accident, loses use of all four limbs and requires complex home health care services delivered by a network of health and social service agencies in a rural area of Kentucky. Economic, psychosocial, ethical, preventive, and medical aspects of health care are discussed. PMID:4090533

  16. [Jean-Jacques Rosseau the vitalist. The moralization of medical hygiene between diet and ethical food].

    PubMed

    Menin, Marco

    2012-01-01

    The historiographical prejudice that sees in Jean-Jacques Rousseau an implacable opponent of scientific knowledge has long prevented an objective evaluation of the important influence that medical thought exerted over his philosophy. The aim of this paper is to show not only Rousseau's familiarity with the most important expressions of eighteenth-century medical literature, but also his willingness to incorporate some medical suggestions in his philosophical and literary production. In the first part of this article, I try to show how Rousseau's sensibility theory presupposes precise medical ideals, related to Montpellier School of vitalism. In the second part, I stress how Rousseau's philosophy of alimentation (which has clear anthropological and political implications) can be regarded as a genuine application of an ambition typical of vitalism: to use medical hygiene, also and above all, for moral purpose. PMID:23035396

  17. Identifying and addressing potential conflict of interest: a professional medical organization's code of ethics.

    PubMed

    Heim, Lori

    2010-01-01

    The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP's adherence to its ethical foundation, demonstrate the AAFP's commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conflict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would--or will in the future--occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to fill that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed. PMID:20644192

  18. Principles of Pedagogy in Teaching in a Diverse Medical School: The University of Capetown South Africa Medical School.

    ERIC Educational Resources Information Center

    Rothenberg, Julia Johnson; Holland, Errol

    This paper describes a 2-month project developed by the Sage Colleges (New York) and the University of Capetown Medical School in South Africa to help the medical faculty at the Capetown Medical School teach its newly diverse student body. The program is intended to improve student retention and it emphasizes the need for faculty to assure…

  19. Ethics & evidence in medical debates: the case of recombinant activated factor VII.

    PubMed

    Ghinea, Narcyz; Lipworth, Wendy; Kerridge, Ian; Little, Miles; Day, Richard O

    2014-01-01

    We cannot just point to the facts to solve a medical debate. The use of evidence is itself a matter of values. What the evidence tells us to do tends to depend on what we see as important. PMID:24532448

  20. Collaborative Family Healthcare Association commentary on the "joint principles: Integrating behavioral health care into the patient-centered medical home".

    PubMed

    Runyan, Christine; Khatri, Parinda

    2014-06-01

    The Collaborative Family Healthcare Association (CFHA) welcomes the opportunity to comment on the complementary set of Joint Principles underscoring the Integration of Behavioral Health Care Into the Patient-Centered Medical Home (The Working Party Group on Integrated Behavioral Healthcare et al., 2014). CFHA is an organization that promotes comprehensive and cost-effective models of health care delivery that integrate mind and body, individual and family, patients, providers, and communities. CFHA appreciates that the Joint Principles do not explicitly endorse any single model of collaboration between behavioral health and medical practice. Rather, they broadly emphasize integration, affirming the only way to have a whole person orientation is to adopt a biopsychosocial-spiritual perspective. This commentary will highlight areas of notable strength within the Joint Principles, as well as challenge the language, if not perspective, on a few critical elements. PMID:24955686

  1. [An ethical and medical perspective on the voluntary termination of pregnancy].

    PubMed

    Echeverría B, Carlos; Serani M, Alejandro; Arriagada U, Ana María; Goic G, Alejandro; Herrera C, Carolina; Quintana V, Carlos; Rojas O, Alberto; Ruiz-Esquide, Gonzalo; Salinas R, Rodrigo; Taboada R, Paulina; Vacarezza Y, Ricardo

    2015-11-01

    "Voluntary termination of pregnancy" can refer to actions intended to make a delivery easier, to provide medical care to the fetus, or to protect the life or health of the mother. All of these are proper medical actions and are by definition voluntary. In other cases, the expression denotes a termination of pregnancy before the embryo or fetus is viable, leading to the death of the latter. This action is constitutive of abortion under current Chilean law. The product of conception living being, who develops in the womb during pregnancy, is an individual, both in the sense that it is different from its mother and father, and in that it is a biological individual. For these reasons, such living being constitutes another patient in itself. The free and voluntary medical action of health care professionals is geared toward disease prevention or health recovery and medical terminations of pregnancy, as distinguished from abortion, are not criminalized in our country. Therefore, the idea of legalizing abortive terminations of pregnancy so that they become "legitimate health care services" is a call to the medical community, which should engage in a debate about the meaning and consequences of an eventual mandate of the State that would be at odds with the Hippocratic tradition. A woman can feel that her health is at risk due to her pregnancy, and she certainly has the right to request medical help. Health professionals should care both at the medical and emotional level for all those who require their services, especially when such persons are undergoing situations of vulnerability and distress. When requested to perform an abortion, the physician faces dilemmas that should be addressed in line with the present state of the medical art. PMID:26757873

  2. Medical narratives and patient analogs: the ethical implications of electronic patient records.

    PubMed

    Kluge, E H

    1999-12-01

    An electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular specialty as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties. PMID:10805009

  3. Morality in flux: medical ethics dilemmas in the People's Republic of China.

    PubMed

    Qiu, Ren-Zong

    1991-03-01

    The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia... More research and discussion among people from various fields is needed. Progress will be made one step at a time, and I recommend that we proceed now to win acceptance of brain death criteria; to make clear the distinctions between passive and active euthanasia,...to encourage the use of living wills; and to protect the interests of newborns who are not terminally ill, including those with mild defects. In the changing context of modernization, in which different and even incompatible value systems must coexist, it is best for us to approach the ethical dilemmas facing us with mutual respect and understanding. PMID:11645699

  4. Biomedical, ethical, and moral issues being forced by advanced medical technologies.

    PubMed

    Satava, Richard M

    2003-09-01

    Technology is rampant, exponentially growing beyond the bounds normally comprehensible by the human mind. Many of these technologies are so fundamentally disruptive that they challenge the very practice of science. Discoveries once unimaginable except in science fiction are appearing at such a rapid rate that there is no time to evaluate their moral and ethical implications in a deliberate and measured fashion. Genetic engineering, human cloning, tissue engineering, intelligent robotics, nanotechnology, suspended animation, regeneration, and species prolongation are but a few that will revolutionize what it means to be human and what the ultimate fate of the species may be. Unless these issues are addressed at this time, we shall face the consequences of an uncontrolled and unprepared future. PMID:14606491

  5. Ethical issues related to computerised family medical histories in sickle cell disease: Inforare.

    PubMed

    Franrenet, Sandra; Duchange, Nathalie; Galactéros, Fréderic; Quantin, Catherine; Cohen, Olivier; Nzouakou, Ruben; Sudraud, Sophie; Hervé, Christian; Moutel, Grégoire

    2010-10-01

    The Inforare project aims to set up a system for the sharing of clinical and familial data, in order to study how genes are related to the severity of sickle cell disease. While the computerisation of clinical records represents a valuable research goal, an ethical framework is necessary to guarantee patients' protection and their rights in this developing field. Issues relating to patient information during the Inforare study were analysed by the steering committee. Several major concerns were discussed by the committee and formalized in the patients' information letter: educating patients to aid the recruitment of family members, rules of confidentiality and the disclosure of aggregate, individual and unexpected research results. This paper presents the main issues addressed. PMID:20826869

  6. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

    PubMed Central

    2014-01-01

    Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339

  7. Turning the history of medical ethics from its head onto its feet: a critical commentary on Baker and McCullough.

    PubMed

    Schmidt, Ulf

    2007-03-01

    The paper provides a critical commentary on the article by Baker and McCullough on Medical Ethic's Appropriation of Moral Philosophy. The author argues that Baker and McCullough offer a more "pragmatic" approach to the history of medical ethics that has the potential to enrich the bioethics field with a greater historical grounding and sound methodology. Their approach can help us to come to a more nuanced understanding about the way in which medical ethics has connected, disconnected, and reconnected with philosophical ideas throughout the centuries. The author points out that Baker and McCullough's model can run the danger of overemphasizing the role of medical ethicists whilst marginalizing the influence of philosophers and of other historical actors and forces. He critically reviews the two case studies on which Baker and McCullough focus and concludes that scholars need to bear in mind the levels of uncertainty and ambivalence that accompany the process of transformation and dissemination of moral values in medicine and medical practice. PMID:17849662

  8. Preconception sex selection for non-medical and intermediate reasons: ethical reflections.

    PubMed

    de Wert, G; Dondorp, W

    2010-01-01

    Sex selection for non-medical reasons is forbidden in many countries. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a 'medical reason' in this context and argue for the existence of 'intermediate reasons' that do not fit well within the rigid distinction between 'medical'and 'non-medical'. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none of these are conclusive. The authors conclude that the ban should be reconsidered, but also that existing-- societal concerns about possible harmful effects should be taken seriously. Measures to this effect may include limiting the practice to couples who already have at least one child of the sex opposite to that which they now want to select ('family balancing'). Finally, a difficult set of questions is raised by concerns about the reliability and unproven (long-term) safety of the only technology (flow cytometry) proven to work. PMID:25009714

  9. Medical ethics in the 1990s. Emphasis on death-and-dying issues will continue but social concerns will command increased attention.

    PubMed

    Drane, J F

    1991-09-01

    During the 1990s medical ethics will undergo changes. Individual clinical issues, especially those related to death and dying, will continue to create conflict and preoccupy hospital staffs. But professional ethicists will focus on social concerns more frequently than they have in the past. Following are some of the most crucial ethical issues and directions they are likely to take in this decade: Clinical practice and the law will move toward less demanding standards of proof regarding the withdrawal of treatment from patients who are no longer competent. Public policy will set more lenient standards for judging whether a person would refuse artificial nutrition and hydration if he or she were able. Unless sensible people strengthen the distinction between active and passive euthanasia, more physicians and legislatures will move toward physician-assisted suicide. Those proposing a higher-brain definition of death, as opposed to whole-brain definitions, will gain ground with the general public, but not with legislators. New transplantation technologies will increase medical options but create more problems with paying for the procedures. As techniques are perfected, ethical questions will focus more on financing than on the source of transplantable material. AIDS treatment priorities will clash with other medical demands (e.g., treatment for breast cancer), and concerns about protecting both providers and patients from contracting AIDS will move policy toward routine testing. Progress in public argument will be made on the abortion issue. Members of ethics committees will have to be trained to address financing issues. Some medical schools and residency programs will add courses on the concept of character and on character development to their ethics programs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10113706

  10. Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective

    PubMed Central

    Pandit, M. S.; Pandit, Shobha

    2009-01-01

    A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment. PMID:19881134

  11. The ethics of insurance limiting institutional medical care: It's all about the money.

    PubMed

    Jones, James W; McCullough, Laurence B

    2016-04-01

    Dr F. Inest practices surgery at a renowned medical center but is concerned because increasing numbers of medical insurers are excluding his institution from coverage. Many of his former referring physicians are beginning to send their patients elsewhere for this reason. The marketing people have been busy increasing their advertising buys and exploring new business models. There is even talk about reducing expensive clinical trials. However, regardless of his affiliation, he has little control over these and other organizational decisions that directly impact his practice clinically and fiscally. What should he do? PMID:27016860

  12. Teaching ethics in Europe

    PubMed Central

    Claudot, Frédérique; Alla, François; Ducrocq, Xavier; Coudane, Henry

    2007-01-01

    Aim To carry out an appropriate overview and inventory of the teaching of ethics within the European Union Schools of Medicine. Methods A questionnaire was sent by email to 45 randomly selected medical schools from each of 23 countries in the European Union in February 2006. Results 25 schools of medicine from 18 European countries were included (response rate?=?56%). In 21 of 25 medical schools, there was at least one ethics module. In 11 of 25 medical schools, the teaching of ethics was transversal. Only one of the responding schools did not teach ethics. The mean time invested in ethics teaching was 44?h during the overall curriculum. Conclusions Ethics now has an established place within the medical curriculum throughout the European Union. However, there is a notable disparity in programme characteristics among schools of medicine. PMID:17664312

  13. The task of nursing ethics.

    PubMed Central

    Melia, K M

    1994-01-01

    This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this is to ask practising nurses about the real ethical problems they encounter. PMID:8035446

  14. The Surgical Treatment of Morbid Obesity: Economic, Psychosocial, Ethical, Preventive, Medical Aspects of Health Care

    PubMed Central

    Wrobel, Sylvia B.; Griffen, Ward O.; Anderson, James W.; Whitaker, E. Berton; Wiegert, H. Thomas; Searle, Maureen; Engelberg, Joseph

    1983-01-01

    Surgical treatment of morbid, familial, juvenile-onset obesity in a 37-year-old, 260-pound, mother of three children by jejunoileal bypass was subsequently converted to gastric bypass. The resulting weight loss of 110 pounds resulted in personality changes and changes in family dynamics and was followed by divorce. Medical, psychosocial, and economic aspects of the case are discussed. PMID:6140795

  15. Sickle Cell Screening: Medical, Legal, Ethical, Psychological and Social Problems; A Sickle Cell Crisis.

    ERIC Educational Resources Information Center

    Bowman, James E.

    In recent years, sickle cell screening programs have been initiated by community groups, health centers, hospitals, medical schools, health departments, school systems, city and State governments, various branches of the Federal Government, fraternal and social clubs, and other organizations. Problems have resulted from mass sickle cell screening,…

  16. Medical professionalism, revenue enhancement, and self-interest: an ethically ambiguous association.

    PubMed

    Heller, Jan C

    2012-12-01

    This article explores the association between medical professionalism, revenue enhancement, and self-interest. Utilizing the sociological literature, I begin by characterizing professionalism generally and medical professionalism particularly. I then consider "pay for performance" mechanisms as an example of one way physicians might be incentivized to improve their professionalism and, at the same time, enhance their revenue. I suggest that the concern discussed in much of the medical professionalism literature that physicians might act on the basis of self-interest is over-generalized, and that instead we ought to argue about ways to distinguish permissible and impermissible self-interested actions. Also, I argue that financial incentives for medical professionals ought to be permissible but considered as "by-products" of doing what physicians are expected to do as professionals in any case. Nevertheless, I conclude that, even if a positive association between increasing professionalism and revenue enhancement can be established, in the long term it may not be an unambiguous good for physicians as professionals in that this association may tend to reduce their professional discretion. PMID:23104549

  17. Sickle Cell Screening: Medical, Legal, Ethical, Psychological and Social Problems; A Sickle Cell Crisis.

    ERIC Educational Resources Information Center

    Bowman, James E.

    In recent years, sickle cell screening programs have been initiated by community groups, health centers, hospitals, medical schools, health departments, school systems, city and State governments, various branches of the Federal Government, fraternal and social clubs, and other organizations. Problems have resulted from mass sickle cell screening,…

  18. Use of Cloud-Based Graphic Narrative Software in Medical Ethics Teaching

    ERIC Educational Resources Information Center

    Weber, Alan S.

    2015-01-01

    Although used as a common pedagogical tool in K-12 education, online graphic narrative ("comics") software has not generally been incorporated into advanced professional or technical education. This contribution reports preliminary data from a study on the use of cloud-based graphics software Pixton.com to teach basic medical ethics…

  19. "Murder or mercy?" An innovative module helping UK medical students to articulate their own ethical viewpoints regarding end-of-life decisions.

    PubMed

    Bell, David; Crawford, Vivienne

    2011-10-01

    This module was designed to equip UK medical students to respond ethically and sensitively to requests encountered as qualified doctors regarding euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment.The module is delivered by a multidisciplinary team, providing students with the working knowledge to actively discuss cases, articulate their own views and practice ethical reasoning. Visits to intensive care units, palliative care wards and hospices are integrated with theory. Student assessment comprises a dissertation, debate and reflection. Module impact was evaluated by analysis of student coursework and a questionnaire.Students greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to cases and debate issues with peers. They reported increased discernment of the ethical and legal position and practical considerations and greater awareness of the range of professional and lay viewpoints held. Many participants were less strongly in favor of euthanasia and assisted dying on module completion than at the outset, but all of them believed they were better equipped to justify their own viewpoint and respond to patient requests. The multi-disciplinary nature of this course helps to prepare students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position. PMID:21941154

  20. Ethics and clinical trials.

    PubMed

    Chassany, O; Duracinský, M

    1999-01-01

    The current reference guideline about ethics in clinical trials is the Declaration of Helsinki of human rights in medical research. Three major principles are emphasised: respect of the patient to accept or not to participate in a trial, the constraints and the presumed risks must be acceptable for patients included in a study, and vulnerable subjects should not participate in studies. The investigator is responsible for obtaining a free and well-informed consent from patients before their inclusion in a study. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. Else, a small-sized trial comparing a new drug versus a reference treatment can lead to an erroneous conclusion of absence of difference. Moreover, good results or improvement are obtained in at least 30% of cases with placebo, whatever the disease. The use of placebo is unethical in life-threatening diseases and when an effective proved drug exists. The use of placebo is ethical in severe diseases with no efficient drug, in some severe diseases even when an active reference treatment is available, and in all moderate and functional diseases. In order to detect flawed studies, most journals now ask for any manuscript submitted and reporting results of a randomised clinical trial to join a checklist in order to verify the quality of the trial. Finally, it remains the responsibility of the doctor to decide whether or not a protocol is ethical, to participate or not and to include patients or not. PMID:10456284

  1. Teaching medical education principles and methods to faculty using an active learning approach: the University of Michigan Medical Education Scholars Program.

    PubMed

    Frohna, Alice Z; Hamstra, Stanley J; Mullan, Patricia B; Gruppen, Larry D

    2006-11-01

    The Medical Education Scholars Program (MESP) at the University of Michigan Medical School was established in 1998 to develop educational leadership, improve teaching skills, and promote educational scholarship among medical school faculty. The Department of Medical Education designed and implemented the program. Eighty-one scholars have completed the MESP, with 15 more currently enrolled. While most scholars have been clinical faculty, some have been basic science faculty or from other allied health fields. The selection process emphasizes potential for contributing to the educational mission of the medical school. Each cohort is limited to two participants per department. The curriculum of the MESP is designed to provide an overview of a wide range of topics in education. It is divided into five broad domains: principles and theories of education, teaching methods, educational research methods, assessment and evaluation, and educational leadership. During the sessions, active learning of content is expected and encouraged. For instance, scholars share responsibility with the session presenters for planning and evaluating individual program sessions. To graduate, scholars are expected to attend the sessions regularly, and to make a final presentation of their project, which demonstrates near-completion or substantial progress toward that goal. Over its eight years, the MESP has evolved in response to environmental changes and ongoing evaluation of the program. Overall, the Medical Education Scholars Program has proven effective in developing faculty skills and educational leadership locally at the University of Michigan Medical School and nationally. PMID:17065859

  2. The quality of medicines: an ethical issue?

    PubMed

    Ravinetto, Raffaella; Schiavett, Benedetta

    2015-01-01

    The Hippocratic maxim, "Do no harm," is a long-standing fundamental principle of medical ethics, encompassing both medical practice and medical research. Yet, not enough attention is given to the implications of this principle for sectors related to medical research and practice, such as the pharmaceutical sector. The regulation of the standards of quality in pharmaceutical production and distribution, for instance, is generally considered a purely technical - rather than ethical - subject. Poor enforcement of regulatory supervision of manufacturers and wholesalers of medicine exposes the end-users to low-quality pharmaceutical products, which will result in avoidable "harm", such as therapeutic failure, emergence of resistance and even direct toxicity. A glaring example of this in recent times was the death, in Pakistan, of 120 cardiovascular patients who had received a medicine contaminated with pyrimethamine (1). Due to the globalisation of the pharmaceutical supply chain and the lack of international regulatory oversight, stringent drug regulatory authorities in affluent countries are also exposed to challenges related to quality. In the USA, for instance, at least four patients died after using contaminated heparin from China (2). These and other unnecessary deaths, caused by medical products which harmed rather than benefited the patients, are unacceptable and should be questioned on ethical grounds. PMID:26592786

  3. Physicians’ attitudes toward medical and ethical challenges for patients in the vegetative state: comparing Canadian and German perspectives in a vignette survey

    PubMed Central

    2014-01-01

    Background Physicians treating patients in the vegetative state (VS) must deal with uncertainty in diagnosis and prognosis, as well as ethical issues. We examined whether physicians’ attitudes toward medical and ethical challenges vary across two national medical practice settings. Methods A comparative survey was conducted among German and Canadian specialty physicians, based on a case vignette about the VS. Similarities and differences of participants’ attitudes toward medical and ethical challenges between the two samples were analyzed with non-parametric tests (Mann-Whitney-U-Test). Results The overall response rate was 13.4%. Eighty percent of all participants correctly applied the diagnostic category of VS with no significant differences between countries. Many of the participants who chose the correct diagnosis of VS attributed capabilities to the patient, particularly the ability to feel pain (70%), touch (51%) and to experience hunger and thirst (35%). A large majority of participants (94%) considered the limitation of life-sustaining treatment (LST) under certain circumstances, but more Canadian participants were in favor of always limiting LST (32% vs. 12%; Chi-square: p?medical practice settings with respect to physicians’ experiences and attitudes about treatment limitation about VS in spite of comparable diagnostic knowledge. PMID:24898329

  4. Research ethics: challenges in the Eastern Mediterranean Region.

    PubMed

    Khayat, M Haytham

    2006-01-01

    The foundations of ethical principles in the Eastern Mediterranean Region can be found within the 3 major religions of the Region; Judaism, Christianity and Islam. Today, there are numerous ethical issues that have emerged as result of the technological advances of the 20th century and this paper addresses some of those related to biomedical research. The Islamic principles in relation to medicine and biomedical research are described, and in particular research involving human subjects. The paper also outlines the endeavours being made by the Islamic Organization for Medical Sciences to address such issues and draw up recommendations and rulings. PMID:17037684

  5. Philosophy of organ donation: Review of ethical facets.

    PubMed

    Dalal, Aparna R

    2015-06-24

    Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail. PMID:26131406

  6. Philosophy of organ donation: Review of ethical facets

    PubMed Central

    Dalal, Aparna R

    2015-01-01

    Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail. PMID:26131406

  7. The elephant in the room: ethical issues associated with rare and expensive medical conditions.

    PubMed

    Mavroudis, Constantine D; Mavroudis, Constantine; Jacobs, Jeffrey P

    2015-12-01

    The treatment of rare and expensive medical conditions is one of the defining qualities of paediatric cardiology and congenital heart surgery. Increasing concerns over healthcare resource allocation are challenging the merits of treating more expensive forms of congenital heart disease, and this trend will almost certainly continue. In this manuscript, the problems of resource allocation for rare and expensive medical conditions are described from philosophical and economic perspectives. The argument is made that current economic models are limited in the ability to assess the value of treating expensive and rare forms of congenital heart disease. Further, multi-disciplinary approaches are necessary to best determine the merits of treating a patient population such as those with significant congenital heart disease that sometimes requires enormous healthcare resources. PMID:26675614

  8. Enhancement, ethics and society: towards an empirical research agenda for the medical humanities and social sciences

    PubMed Central

    Hogle, Linda

    2015-01-01

    For some time now, bioethicists have paid close attention to issues associated with ‘enhancement’; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with ‘normal’ function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with—and further develop—existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to—and be benefitted by—research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates. PMID:26260624

  9. Preconception sex selection for non-medical and intermediate reasons: ethical reflections

    PubMed Central

    de Wert, G.; Dondorp, W.

    2010-01-01

    Sex selection for non-medical reasons is forbidden in many countries. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a ‘medical reason’ in this context and argue for the existence of ‘intermediate reasons’ that do not fit well within the rigid distinction between ‘medical’and ‘non-medical’. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none of these are conclusive. The authors conclude that the ban should be reconsidered, but also that existing societal concerns about possible harmful effects should be taken seriously. Measures to this effect may include limiting the practice to couples who already have at least one child of the sex opposite to that which they now want to select (‘family balancing’). Finally, a difficult set of questions is raised by concerns about the reliability and unproven (long-term) safety of the only technology (flow cytometry) proven to work. PMID:25009714

  10. Enhancement, ethics and society: towards an empirical research agenda for the medical humanities and social sciences.

    PubMed

    Pickersgill, Martyn; Hogle, Linda

    2015-12-01

    For some time now, bioethicists have paid close attention to issues associated with 'enhancement'; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with 'normal' function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with-and further develop-existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to-and be benefitted by-research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates. PMID:26260624

  11. Jehovah's Witness parents' refusal of blood transfusions: Ethical considerations for psychologists.

    PubMed

    Hoffman, Anna

    2014-12-01

    Psychologists in medical settings may be confronted with Jehovah's Witness parents refusing blood transfusions for their children as an ethical dilemma. The purpose of this discussion is to help psychologists provide informed, ethical consultations and support by investigating the values of the Jehovah's Witness community and the origin of the blood transfusion taboo, how medical and legal professionals have approached this dilemma, exploring relevant ethical principles and standards for psychologists, and suggestions for how to move toward a better understanding of harm with Jehovah's Witness families. PMID:25476572

  12. [An ancient surgical set in the history of medicine museum at the medical history and ethics department at Cerrahpa?a Medical School].

    PubMed

    Uzel, I

    1995-01-01

    The present head of the Department of Medical History and Ethics, Prof. Dr. Nil Sari founded a museum for the history of medicine within the Department. A set of surgical instruments, granted by Prof. Dr. M. Kemal Oke and Prof. Dr. Fuat Kâmil Berksan to the Department, is studied in this article. The set, all made of bronze, and dating approximately back to the IVth century B.C. consists of four bistouries, two pincets, two bone catheters, a cauterization instrument, a spatula, curettage instrument and an unidentified piece. They do not have any trace of corrosion. No sign, badge or stamp can be detected on the instruments. Apparently they have not been used much. The skilfull handicraft, harmonious and excellent style of the set suggest that they might have been produced by an artist or in accordance with the description of a master surgeon. Presence of a pincet for eye surgery suggests that the owner might have been an ophtalmologist. Since the granters had not given any clue of the site they were discovered, it is hard to determine where or by whom the set was made. PMID:11625066

  13. Some ethical dilemmas faced by Jewish doctors during the Holocaust.

    PubMed

    Chelouche, Tessa

    2005-12-01

    The discourse on physicians and ethics in the Nazi regime usually refers to the violation of medical ethics by Nazi doctors who as a guild and as individuals applied their professional knowledge, training and status in order to facilitate murder and medical "experimentation". In the introduction to this article I will give a brief outline of this vast subject. In the main article I wish to bear witness to the Jewish physicians in the ghettos and the camps who tried to the best of their ability to apply their professional training according to ethical principles in order to prolong life as best as they could, despite being forced to exist and work under the most appalling conditions. These prisoner doctors were faced with impossible existential, ethical and moral dilemmas that they had not encountered beforehand. This paper addresses some of these ethical quandaries that these prisoner doctors had to deal with in trying to help their patients despite the extreme situations they found themselves in. This is an overview of some of these ethical predicaments and does not delve into each one separately for lack of space, but rather gives the reader food for thought. Each dilemma discussed deserves an analysis of its own in the context of professionalism and medical ethics today. PMID:16440865

  14. A clinico-ethical framework for multidisciplinary review of medication in nursing homes.

    PubMed

    Baqir, Wasim; Barrett, Steven; Desai, Nisha; Copeland, Richard; Hughes, Julian

    2014-01-01

    Residents in care homes are more likely to be prescribed multiple medicines yet often have little involvement in these prescribing decisions. Reviewing and stopping inappropriate medicines is not currently adopted across the health economy. This Health Foundation funded Shine project developed a pragmatic approach to optimising medicines in care homes while involving all residents in decision making. The pharmacist undertook a detailed medication review using primary care records. The results were discussed at a multidisciplinary team (MDT) meeting involving the care home nurse and the resident's general practitioner (GP), with input from the local psychiatry of old age service (POAS) where appropriate. Suggestions for medicines which should be stopped, changed or started, and other interventions (eg monitoring) were discussed with the resident and/or their family. Over 12 months 422 residents were reviewed, and 1346 interventions were made in 91% of residents reviewed with 15 different types of interventions. The most common intervention (52.3%) was to stop medicines; 704 medicines stopped in 298 residents (70.6%). On average, 1.7 medicines were stopped for every resident reviewed (range zero to nine medicines; SD=1.7), with a 17.4% reduction in medicines prescribed (3602 medicines prescribed before and 2975 after review). The main reasons for stopping medicines were: no current indication (401 medicines; 57%), resident not wanting medicine after risks and benefits were explained (120 medicines; 17%), and safety concerns (42 medicines; 6%). The net annualised savings against the medicines budget were £77,703 or £184 per person reviewed. The cost of delivering the intervention was £32,670 (pharmacist, GP, POAS consultant, and care home nurse time) for 422 residents; for every £1 invested, £2.38 could be released from the medicines budget. This project demonstrated that a multidisciplinary medication review with a pharmacist, doctor, and care home nurse can safely reduce inappropriate medication in elderly care home residents. PMID:26734305

  15. [Advance Care Planning and Decisions to limit treatment at the end of life - the view from medical ethics and psychooncology].

    PubMed

    Winkler, Eva C; Heußner, Pia

    2016-03-01

    Decisions to limit treatment are important in order to avoid overtreatment at the end of life. They proceed more than half of expected deaths in Europe and the US, but are not always communicated with the patient in advance. One reason for non-involvement is that conversations that prepare patients for end-of-life decisions and work out their preferences do not take place on a regular basis. At the same time there is growing evidence that such communication improves patients' quality of life, reduces anxiety and depression and allows patients to develop a realistic understanding of their situation - which in turn is a prerequisite for shared decision making about limiting treatment.In this paper we define "treatment limitation" and explain the medical ethics perspective. The main focus, however, is on the causes that hinder advanced care planning and conversations about limiting treatment in the care of patients with advanced disease. Finally the evidence for approaches to improve the situation is presented with concrete suggestions for solutions. PMID:26983109

  16. Ethical Challenges of Medicine and Health on the Internet: A Review

    PubMed Central

    2001-01-01

    Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role that medicine and health play in the growing area of Internet communication and commerce and many of the ethical challenges raised by the Internet for the medical community are explored and some possible ways to address these ethical challenges are postulated. PMID:11720965

  17. Ethical challenges of medicine and health on the Internet: a review.

    PubMed

    Dyer, K A

    2001-01-01

    Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role that medicine and health play in the growing area of Internet communication and commerce and many of the ethical challenges raised by the Internet for the medical community are explored and some possible ways to address these ethical challenges are postulated. PMID:11720965

  18. [Paracelsianism, astrology and medical ethics in the polemical writings of Tommaso Bovio (1521-1609)].

    PubMed

    Bondio, Mariacarla Gadebusch

    2004-01-01

    Tommaso Bovio was a representative of North Italian non-academic medicine in the early modern period. His "dialogues", published in the second half of the 16th century, were written in the Italian vernacular and enjoyed a certain popularity also in Germany. Although Bovio used to exaggerate for rhetorical effect, his portrayal of patients, illness and treatments provides interesting insights into everyday urban life in his time. Sympathising with Paracelsus, Bovio propagated an image of empirics as humanitarians and fought for the recognition of his own practical knowledge and skills. Bovio was a most original figure in the medicine of the period of counter reformation. His writings exemplify the lively debate between the learned medical tradition and unorthodox reform. PMID:15015853

  19. The Case of Pharmacological Neuroenhancement: Medical, Judicial and Ethical Aspects from a German Perspective.

    PubMed

    Franke, A G; Northoff, R; Hildt, E

    2015-11-01

    Pharmacological neuroenhancement (PN) describes the use of psychoactive drugs for the purpose of enhancing cognition (e. g., fatigue, concentration, memory etc.) by healthy subjects without medical need. Drugs used for this purpose can be divided into freely available, over-the-counter drugs (e. g., methylxanthines such as caffeine), prescription drugs (e. g., antidementia drugs, methylphenidate) and illicit drugs (e. g., illicit amphetamines). Clinical studies have shown that the aforementioned substances only have limited pro-cognitive effects and have considerable safety risks and side effects.The German judicial perspective shows legal differences between substances (drugs, food, food supplements, fortified food) that can be bought in a supermarket, drugs that can be bought in a pharmacy as over-the-counter- (OTC-) drugs, drugs with or without the need for a prescription and illicit drugs. Supermarket drugs and fortified food can be sold freely and follow the general rules of civil and penal law; regarding acquisition, parents are responsible for their children. OTC drugs require special information about therapy. Regarding prescription drugs, there are legal problems caused by an off-label use and the non-medical purposes of PN drugs. Furthermore, prescription stimulants for PN are governed by the specialized law for narcotics, and their use might be punished. Beyond the general lack of rules for regulation for PN drug use there are specific needs for prevention (e. g., control of the black market, etc.).Possible future policy will depend, among others, on the probability with which effective PN drugs with an acceptable risk-benefit ratio will be available, on individual and societal implications, and on public opinion towards PN. While 4 different general policy scenarios can be identified, it is important to advance a broad societal debate on PN to collect relevant empirical data and to address enhancement-related conceptual issues. PMID:26252723

  20. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed

    Haines, A; de B White, C; Gleisner, J

    1983-12-01

    The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585

  1. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed Central

    Haines, A; de B White, C; Gleisner, J

    1983-01-01

    The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585

  2. Feasibility of rapid ethical assessment for the Ethiopian health research ethics review system.

    PubMed

    Addissie, Adamu; Davey, Gail; Newport, Melanie; Farsides, Bobbie; Feleke, Yeweyenhareg

    2015-01-01

    One of the challenges in the process of ethical medical research in developing countries, including Ethiopia, is translating universal principles of medical ethics into appropriate informed consent documents and their implementation. Rapid Ethical Assessment (REA) has been suggested as a feasible approach to meet this application gap. In the past few years REA has been employed in few research project in Ethiopia and have been found to be a useful and practical approach. Feasibility assessment of REA for the Ethiopian research setting was conducted between 2012-2013 in order to inform the subsequent introduction of REA into research ethics review and governance system in the country. REA was found to be an appropriate, relevant and feasible venture. We argue that REA can be integrated as part of the ethics review and governance system in Ethiopia. REA tools and techniques are considered relevant and acceptable to the Ethiopian research community, with few practical challenges anticipated in their implementation. REA are considered feasible for integration in the Ethiopian ethics review system. PMID:25816498

  3. Publication ethics and scientific misconduct.

    PubMed

    Peh, W C G; Ng, K H

    2010-12-01

    To maintain the readers' trust and to uphold the journal's reputation, it is paramount for the entire research, peer reviewer and publication process to follow ethical principles and decisions. Studies involving humans, animals, medical records and human tissues/organs need to be conducted ethically, and the appropriate approvals obtained. The privacy and confidentiality of patients, authors and reviewers should be respected. When required, rights and permissions should be sought. Common forms of scientific misconduct include misappropriation of ideas, violation of generally accepted research practices, failure to comply with legislative and regulatory requirements, falsification of data, and inappropriate behaviour in relation to misconduct. Authors can expect editorial action to be taken, should duplicate publication, plagiarism and other forms of scientific misconduct be attempted or detected. PMID:21221494

  4. A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

    PubMed

    Ferrie, Suzie

    2006-04-01

    Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems. PMID:16556920

  5. [Medical ethics in the world's market. Hippocratic fidelity or enterprise fidelity].

    PubMed

    Roncoroni, A J

    2000-01-01

    The advance which resulted in the mean survival increase from 50 to 75 years between 1920 and 1990 also provoked the rise in health care costs, and the so called "health crisis". In order to contain it, market tactics were put to action, health care was considered a commodity, patients "consumers" and hospitals or physicians "providers". Economists, accountants and business advisors in charge of "Health Maintenance Organizations" (HMO) started the very profitable activity of intervening between patients and physicians. Rationing, use of general practice guides, suboptimal treatments, risk avoidance and other market tactics changed the practice of a profession into a business enterprise. The HMO decides if, when, how and how much will be given to any "consumer". Use of technology more impersonal and easily administered is the leading feature of to-day's medicine over the intellectual activity of the physician who hears, understands, makes the physical examination, diagnosis and treatment. The increasing depreciation of his task obliges the physician to enlarge the number and decrease his communication with his patients. His fiduciary obligation is subordinated to market needs and his practice increasingly compromises his moral integrity. The HMO boasts of the quality of the service given, this is the timely use of to-day's appropriate resources. Nobody wants the 1950 car or medical practice. Tomorrow's practice however depends on increasing knowledge, that is, on research, an activity which is not the HMO object. The academic-medical center, the very place where the interaction of teaching and investigating promotes the excellence is discriminated by the HMO because of its compromise with fiduciary activity imposed by 2500 years of jewish-christian philosophy. The future of these institutions (state's Cinderella's) is progressively compromised; when we loose them how long will it take to recover them? The politicians are always ready to create new hospitals, after they are built consuming large amounts of money, they become disinterested. All hospitals in our country are completely active only 4 hours/day, their physicians travel afterwards to their diverse places of activity consuming much of their time in getting there and complying with the bureaucratic tasks imposed by HMO. In our country with 14% unemployment and 1/3 of the population without any health coverage, the institution of universal health insurance is mandatory. Preventive medicine is not effective for people who lack the means for adequate nutrition, education or transportation, they do not visit doctors or use medicines. PMID:10835703

  6. [Ethical aspects of plastic surgery].

    PubMed

    Coli?, M

    1989-01-01

    In the past few years the abuse of ethical principles in plastic surgery has become increasingly noticeable. The reasons are various; it may be the desire to achieve personal recognition of plastic surgeons by means of different press articles or numerous yellow-press articles written by journalists whose only aim is to increase the circulation of their newspapers. In extreme cases the violation of medical secret or the surgeon's personality advertising is noticeable. Although this phenomenon is much more evident in the countries where plastic surgery is being performed at private clinics, it has in the past few years also become more obvious in our country. These ethical problems are present in plastic surgery because it is to often identified with aesthetic surgery. The fact that, with its more or less favorable results, it appears highly attractive to the public and thus get even the unwilling surgeon into the focus of various yellow-press articles and headlines. On the other hand, the very nature of the individual who specializes in this kind of surgery may be the principal basis for publicity. Such abuse of professional ethics is usually explained by claiming that the public should be properly informed, but in some cases it is but open advertising of the surgeon and his/her abilities. Establishing an ethical code which would entail all necessary moral sanctions in plastic surgery would act favorably to the protection of those plastic surgeons who perform their work according to the moral and ethical principles of their profession. PMID:2489525

  7. [Transparency of medical quality data. Ethical obligation to deliver or instrument to create unfair competitive advantage?].

    PubMed

    Ennker, J; Albert, A; Thanner, M; Nagel, E; Rosendahl, U; Ennker, I

    2009-10-01

    Annually about 100,000 acute cardiac deaths occur in Germany. For this reason, there is the obvious need, from a public health perspective, to inform the population about possible measures of their prevention and treatment. Ultimately every patient or admission referring doctor can be thought of as a recipient of "marketing". Other than within the context of economics, in medicine the subject of marketing is likely to produce a negative response. Any doctor engaging in marketing is quickly considered to be engaging in unfair competition at the expense of colleagues ("economic competitors"). However, despite some reservations it would seem sensible to provide transparency concerning the results of treatment. If the manner of competition is the right one, i.e. one that has as its aim to improve patient care, it can at the same time improve such care, motivate doctors and frequently also reduce costs. Transparency of the various aspects of improved medical care in this way represent a "pay-back" to everyone working in the health services. It is desirable to establish an external process of assessing any published data and, as far as possible, exclude all incorrect data from relevant measures of comparison. Competition can then be to the patient's benefit. PMID:19834836

  8. The NAFSA Ethics Program. Ethical Practice in International Educational Exchange.

    ERIC Educational Resources Information Center

    NAFSA - Association of International Educators, Washington, DC.

    This booklet contains complete information on the NAFSA Ethics Program developed by NAFSA: the Association of International Educators. It includes the NAFSA Code of Ethics, the Principles of International Educational Exchange, and details of procedures for ethics-related complaints. The Association of International Educators promotes the exchange…

  9. Living Organ Donation: An Ethical Evolution or Evolution of Ethics?

    PubMed Central

    Ghahramani, N.

    2010-01-01

    The disparity between available and needed organs is rapidly increasing, and the number of patients dying while still on the waiting list is growing exponentially. As a partial solution to this disparity, living unrelated transplantation is being performed more frequently, and some have proposed providing financial incentives to donors. The aim of this discussion is to illustrate that with an ever-increasing number of living unrelated transplantations, society and the transplant community should adopt a more active role in developing specific strategies to scrutinize the process. The current paper will also examine the viewpoint that medical ethics is not separable from the prevailing needs of society and involves a constant balancing of often opposing goods. Issues surrounding living unrelated donor transplantation illustrate ethics as a dynamically evolving field, which is often influenced by necessity and which evolves with progression of science and society. As part of this evolution, it is the collective responsibility of society and the transplant community to devise safeguards to guarantee adherence to basic principles of ethics and to avoid “situational ethics.” PMID:25013566

  10. Code of Ethics.

    ERIC Educational Resources Information Center

    Sheppard, Glenn W.; Schulz, William E.; McMahon, Sylvia-Anne

    This booklet expresses the ethical principles and values of the Canadian Counseling Association and serves as a guide to the professional conduct of all its members. It also informs the public served by the association of the standards of ethical conduct for which members are to be responsible and accountable. This guide reflects the values of…

  11. Code of Ethics

    ERIC Educational Resources Information Center

    Division for Early Childhood, Council for Exceptional Children, 2009

    2009-01-01

    The Code of Ethics of the Division for Early Childhood (DEC) of the Council for Exceptional Children is a public statement of principles and practice guidelines supported by the mission of DEC. The foundation of this Code is based on sound ethical reasoning related to professional practice with young children with disabilities and their families…

  12. Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps.

    PubMed

    Greenwald, Jeffrey L; Halasyamani, Lakshmi; Greene, Jan; LaCivita, Cynthia; Stucky, Erin; Benjamin, Bona; Reid, William; Griffin, Frances A; Vaida, Allen J; Williams, Mark V

    2010-10-01

    Medication errors and adverse events caused by them are common during and after a hospitalization. The impact of these events on patient welfare and the financial burden, both to the patient and the healthcare system, are significant. In 2005, The Joint Commission put forth medication reconciliation as National Patient Safety Goal (NPSG) No. 8 in an effort to minimize adverse events caused during these types of care transitions. However, the meaningful and systematic implementation of medication reconciliation, as expressed through NPSG No. 8, proved to be extraordinarily difficult for healthcare institutions around the country. Given the importance of accurate and complete medication reconciliation for patient safety occurring across the continuum of care, the Society of Hospital Medicine convened a stakeholder conference in 2009 to begin to identify and address: (1) barriers to implementation; (2) opportunities to identify best practices surrounding medication reconciliation; (3) the role of partnerships among traditional healthcare sites and nonclinical and other community-based organizations; and (4) metrics for measuring the processes involved in medication reconciliation and their impact on preventing harm to patients. The focus of the conference was oriented toward medication reconciliation for a hospitalized patient population; however, many of the themes and concepts derived would also apply to other care settings. This paper highlights the key domains needing to be addressed and suggests first steps toward doing so. An overarching principle derived at the conference is that medication reconciliation should not be viewed as an accreditation function. It must, first and foremost, be recognized as an important element of patient safety. From this principle, the participants identified ten key areas requiring further attention in order to move medication reconciliation toward this focus. 1 There is need for a uniformly acceptable and accepted definition of what constitutes a medication and what processes are encompassed by reconciliation. Clarifying these terms is critical to ensuring more uniform impact of medication reconciliation. 2 The varying roles of the multidisciplinary participants in the reconciliation process must be clearly defined. These role definitions should include those of the patient and family/caregiver and must occur locally, taking into account the need for flexibility in design given the varying structures and resources at healthcare sites. 3 Measures of the reconciliation processes must be clinically meaningful (i.e., of defined benefit to the patient) and derived through consultation with stakeholder groups. Those measures to be reported for national benchmarking and accreditation should be limited in number and clinically meaningful. 4 While a comprehensive reconciliation system is needed across the continuum of care, a phased approach to implementation, allowing it to start slowly and be tailored to local organizational structures and work flows, will increase the chances of successful organizational uptake. 5 Developing mechanisms for prospectively and proactively identifying patients at risk for medication-related adverse events and failed reconciliation is needed. Such an alert system would help maintain vigilance toward these patient safety issues and help focus additional resources on high risk patients. 6 Given the diversity in medication reconciliation practices, research aimed at identifying effective processes is important and should be funded with national resources. Funding should include varying sites of care (e.g., urban and rural, academic and nonacademic, etc.). 7 Strategies for medication reconciliation-both successes and key lessons learned from unsuccessful efforts-should be widely disseminated. 8 A personal health record that is integrated and easily transferable between sites of care is needed to facilitate successful medication reconciliation. 9 Partnerships between healthcare organizations and community-based organizations create opportunities to reinforce medication

  13. [Personalization concepts of medical ethics in the teachings of John Paul II].

    PubMed

    Guba?a, W

    1998-01-01

    According to John Paul's teaching, the medicine cannot be purely technological, but needs to have some human character. The medicine doctors should consider patients as a whole, not only their problems bound with the treating them as patients, and to cure them from their illnesses, but together considering their feelings, and their intellectual and spiritual life. John Paul's teaching in relation to "the personalizing of medicine" means such a consideration of the human being that is leading to the respect about the body, spirit and their culture. Therefore the knowledge about the biological properties of human life, should be accompanied together with the look onto their dignity. Nobody could be a doctor who cures only one organ of the human's body, but must see the whole human person together with the relations to other persons connected with that patient, because they have very often much of influence on to the health of a patient. That "personalizing of the medicine" should be done on such a way, when it is seen the total ill person. The doctor should be having friendly and even heartily personal relationship to the patient, which should lead to a dialog between them, full of respect and confidence. Nobody is allowed to consider an ill person as a clinical case, but should see a person who is expecting not only professional, competent medical attention, but also the understanding of the patient's spirit, which is being bound with that illness. In this way, John Paul II is telling us, that the health service should not be based entirely on the professional knowledge and skill. The doctor should see in the ill person his own dearest brother or sister, whom we are to love very much, and should be taking part in the illnesses of them. PMID:10816965

  14. Medical Assistant. [FasTrak Specialization Integrated Technical and Academic Competency (ITAC).] 2002 Revision.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.

    This curriculum for a medical assistant program is designed for students interested in caring for the sick, injured, convalescent, or disabled under the direction of the family, physicians, and credentialed nurses. The curriculum is divided into 12 units: orientation to medical assisting; principles of medical ethics; risk management; infection…

  15. [Save for eternity: principles of medical science in the age of Montaigne and Cervantes].

    PubMed

    Lopes, Marcos Antônio

    2009-01-01

    This article approaches the medical arts at a time in which therapies are based on empirical knowledge, dictated by the fallacy of the authority ofunshakeable traditions. "Madness" and "eccentricities" perpetuated by Old School medical craftsmen are prevalent today in the strange practices of the new charlatanism, such as trunk cell technologies. PMID:19824332

  16. The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics - A Study of Medical Ethics Using Immersive Virtual Reality

    PubMed Central

    Pan, Xueni; Slater, Mel; Beacco, Alejandro; Navarro, Xavi; Bellido Rivas, Anna I.; Swapp, David; Hale, Joanna; Forbes, Paul Alexander George; Denvir, Catrina; de C. Hamilton, Antonia F.; Delacroix, Sylvie

    2016-01-01

    Background Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner’s daily routine. This study explores the extent to which portable Immersive Virtual Reality technology can help us gain an accurate understanding of the factors that influence a doctor’s response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas. Experiment Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously. Results Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants’ level of presence (together with participants’ feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening. PMID:26889676

  17. Ethical Dilemmas in Family Therapy.

    ERIC Educational Resources Information Center

    Green, Susan L.; Hansen, James C.

    1986-01-01

    Reviewing literature on ethical dilemmas facing family therapists reveals issues not included in the American Association for Marriage and Family Therapy's "Principles for Family Therapists" (1984). Family therapists (N=75) were asked what ethical dilemmas they faced and how helpful the ethical guidelines were. They reported encountering…

  18. Observations on ethical problems and terminal care.

    PubMed Central

    Fischer, D. S.

    1992-01-01

    Progress in medical diagnosis and therapy has raised new problems with far-reaching ethical implications. Medicine must remain a profession and not become a business. Textbooks must address ethical problems in the context of health care decisions and not restrict themselves to pathophysiology and practical therapeutics alone. The relative roles of the principles of autonomy, non-maleficence, beneficence, and justice must be balanced and appropriately applied to individual situations in biomedical ethics. When therapy becomes futile and the suffering of the patient does not justify any anticipated benefit, the patient (and/or patient surrogate) may request withholding or even withdrawing life-prolonging interventions. In the persistent vegetative state, even nutritional support by an unnatural (tube) route may ethically be denied at the patient's (or surrogate's) informed decision. New areas of ethical evaluation have been raised by the desire of some individuals to prolongation of their lives at high expense to the society such that other individuals are denied services because of limitation of available resources. There has been a long-standing conflict of interest between the acceptance by physicians and/or medical institutions of money or gifts from pharmaceutical companies whose drugs they prescribe, stock, or sell. This practice increases the cost of the drugs and is, in effect, a "sick tax," which is morally wrong. PMID:1519374

  19. Ethics in age estimation of unaccompanied minors.

    PubMed

    Thevissen, P W; Kvaal, S I; Willems, G

    2012-11-01

    Children absconding from countries of conflict and war are often not able to document their age. When an age is given, it is frequently untraceable or poorly documented and therefore questioned by immigration authorities. Consequently many countries perform age estimations on these children. Provision of ethical practice during the age estimation investigation of unaccompanied minors is considered from different angles: (1) The UN convention on children's rights, formulating specific rights, protection, support, healthcare and education for unaccompanied minors. (2) Since most age estimation investigations are based on medical examination, the four basic principles of biomedical ethics, namely autonomy, beneficence, non-malevolence, justice. (3) The use of medicine for non treatment purposes. (4) How age estimates with highest accuracy in age prediction can be obtained. Ethical practice in age estimation of unaccompanied minors is achieved when different but related aspects are searched, evaluated, weighted in importance and subsequently combined. However this is not always feasible and unanswered questions remain. PMID:23221269

  20. Preemptive kidney transplantation: ethical issues.

    PubMed

    Petrini, Carlo

    2009-01-01

    Preemptive kidney transplantation, as a treatment modality for end-stage renal disease, offers higher clinical advantages compared to maintenance dialysis. Nevertheless, preemptive transplantations raises ethical concerns, particularly regarding medical resource allocation. From an ethical perspective, health care decisions should be focused on the patient's needs. Nevertheless, a fair distribution model also requires the settlement of general policy decisions. The first part of the paper presents general ethical principles to be followed in organ allocation. The second part summarizes main advantages of preemptive transplantation in terms of clinical outcomes, survival (of both patients and grafts) and quality of life. The third section adds some suggestions for the fulfilment of general principles in the context of preemptive transplantation. The need to find an adequate balance of benefit (maximization of utility) and justice (fairness in organ allocation) is analyzed. A common set of rules for organ allocation should be adopted: fairness and transparency requires the prior definition of sound criteria for the allocation of scarce resources. PMID:19636169

  1. Coordinating the norms and values of medical research, medical practice and patient worlds—the ethics of evidence based medicine in orphaned fields of medicine

    PubMed Central

    Vos, R; Willems, D; Houtepen, R

    2004-01-01

    It appears that the primary ethical problem in this context is the lack of attention to the orphaned fields. Although we agree that this issue deserves more attention as a matter of potential injustice, we want to argue that, in order to do justice to the interplay of heterogeneous factors that is so typical of the orphaned fields, other ethical models than justice are required. We propose the coordination model as a window through which to view the important ethical issues which relate to the communication and interaction of scientists, health care workers, and patients. PMID:15082811

  2. A principled and cosmopolitan neuroethics: considerations for international relevance

    PubMed Central

    2014-01-01

    Neuroethics applies cognitive neuroscience for prescribing alterations to conceptions of self and society, and for prescriptively judging the ethical applications of neurotechnologies. Plentiful normative premises are available to ground such prescriptivity, however prescriptive neuroethics may remain fragmented by social conventions, cultural ideologies, and ethical theories. Herein we offer that an objectively principled neuroethics for international relevance requires a new meta-ethics: understanding how morality works, and how humans manage and improve morality, as objectively based on the brain and social sciences. This new meta-ethics will simultaneously equip neuroethics for evaluating and revising older cultural ideologies and ethical theories, and direct neuroethics towards scientifically valid views of encultured humans intelligently managing moralities. Bypassing absolutism, cultural essentialisms, and unrealistic ethical philosophies, neuroethics arrives at a small set of principles about proper human flourishing that are more culturally inclusive and cosmopolitan in spirit. This cosmopolitanism in turn suggests augmentations to traditional medical ethics in the form of four principled guidelines for international consideration: empowerment, non-obsolescence, self-creativity, and citizenship. PMID:24387102

  3. A principled and cosmopolitan neuroethics: considerations for international relevance.

    PubMed

    Shook, John R; Giordano, James

    2014-01-01

    Neuroethics applies cognitive neuroscience for prescribing alterations to conceptions of self and society, and for prescriptively judging the ethical applications of neurotechnologies. Plentiful normative premises are available to ground such prescriptivity, however prescriptive neuroethics may remain fragmented by social conventions, cultural ideologies, and ethical theories. Herein we offer that an objectively principled neuroethics for international relevance requires a new meta-ethics: understanding how morality works, and how humans manage and improve morality, as objectively based on the brain and social sciences. This new meta-ethics will simultaneously equip neuroethics for evaluating and revising older cultural ideologies and ethical theories, and direct neuroethics towards scientifically valid views of encultured humans intelligently managing moralities. Bypassing absolutism, cultural essentialisms, and unrealistic ethical philosophies, neuroethics arrives at a small set of principles about proper human flourishing that are more culturally inclusive and cosmopolitan in spirit. This cosmopolitanism in turn suggests augmentations to traditional medical ethics in the form of four principled guidelines for international consideration: empowerment, non-obsolescence, self-creativity, and citizenship. PMID:24387102

  4. Brief History of pharmacy ethics in Iran

    PubMed Central

    Farsam, Hassan

    2009-01-01

    Pharmacy is an ethical profession. The aim of this study was to investigate the history of pharmacy ethics in Iran. In the ancient Persia, medical and pharmaceutical ethics were related to religious rules, and everybody had to respect it. The ethical rules were similar to some current pharmacy ethics. During Islamic era, the pharmacy ethics were edited according to the Islamic rules. After introduction of European pharmacy into Iran, the pharmacy ethics did not change and was regarded as before. By presentation of bioethics and medical ethics in recent years, new activities are carried out for better manipulation of their rules in health professions including pharmacy. PMID:23908727

  5. Community-based applied research with Latino immigrant families: informing practice and research according to ethical and social justice principles.

    PubMed

    Baumann, Ana; Domenech Rodríguez, Melanie; Parra-Cardona, José Rubén

    2011-06-01

    This manuscript describes the implementation of two community-based programs of research with Latino immigrant populations exposed to intense contextual challenges. We provide background on our program of research and specific implementation of an evidence-based parenting intervention. We also describe how our research efforts were seriously affected by immigration-related events such as the ICE raids in Utah and a history of discrimination and exclusion affecting Latino immigrants in Michigan. These external political and social challenges have affected the very core principles of our efforts to implement community-based approaches. The current manuscript describes key lessons that we have learned in this process. Finally, reflections for research, practice, and social policy are included. PMID:21564057

  6. The Medical Interaction Laboratory--Multidiscipline Approach for Presentation of Principles of Physiology and Pharmacology.

    ERIC Educational Resources Information Center

    Oliver, Jack W.; Sims, Michael H.

    1979-01-01

    An interdisciplinary physiology and pharmacology course presented by the Medical Interaction Laboratory at the University of Tennessee College of Veterinary Medicine provides interaction among faculty, conserves faculty time and animal expense, and presents a coordinated laboratory experience. (BH)

  7. Ethical Considerations of Community-based Participatory Research: Contextual Underpinnings for Developing Countries

    PubMed Central

    Jamshidi, Ensiyeh; Morasae, Esmaeil Khedmati; Shahandeh, Khandan; Majdzadeh, Reza; Seydali, Elham; Aramesh, Kiarash; Abknar, Nina Loori

    2014-01-01

    Background: The nature of community-based participatory research (CBPR) poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers’ time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. Methods: This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations (NGOs) participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. Results: Four CBPR ethical guidelines (including 173 articles) were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. Conclusions: Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged. PMID:25400893

  8. Views of Ethical Best Practices in Sharing Individual-Level Data From Medical and Public Health Research: A Systematic Scoping Review.

    PubMed

    Bull, Susan; Roberts, Nia; Parker, Michael

    2015-07-01

    There is increasing support for sharing individual-level data generated by medical and public health research. This scoping review of empirical research and conceptual literature examined stakeholders' perspectives of ethical best practices in data sharing, particularly in low- and middle-income settings. Sixty-nine empirical and conceptual articles were reviewed, of which, only five were empirical studies and eight were conceptual articles focusing on low- and middle-income settings. We conclude that support for sharing individual-level data is contingent on the development and implementation of international and local policies and processes to support ethical best practices. Further conceptual and empirical research is needed to ensure data sharing policies and processes in low- and middle-income settings are appropriately informed by stakeholders' perspectives. PMID:26297745

  9. Attention deficit hyperactivity disorder: legal and ethical aspects.

    PubMed

    Foreman, D M

    2006-02-01

    Attention deficit-hyperactivity disorder (ADHD) remains a controversial disorder, despite it now being a well validated clinical diagnosis. Ethical and legal issues are important in determining how doctors should behave in offering a diagnosis or treatment that may generate strong and unpredictable reactions from children, their families, or other agencies. A model for routine ethical practice was proposed, based on three sets of assumptions. Firstly, that ethical practice is consistent with the four principles of beneficence, non-maleficence, justice, and respect for autonomy. Secondly, ethical concerns lead to legal processes, whose task is to ensure ethical practice. Thirdly, that we are working in the interests of our patients. Current relevant literature was organised in terms of this model, and recommendations for practice derived from it. Though there is no general ethical problem regarding either the routine diagnosis or treatment of ADHD, ethical difficulties surround some special cases, especially when doctors are working in conjunction with other agencies or coping with non-medical frameworks. Particular care needs to be taken with confidentiality and consent, the limits of which are currently confused. The model worked well with everyday ethical problems, though more difficult cases required careful individual scrutiny. PMID:16428370

  10. Financial incentives for organ procurement. Ethical aspects of future contracts for cadaveric donors. Council on Ethical and Judicial Affairs, American Medical Association.

    PubMed

    1995-03-27

    Resolution 6, introduced at the 1993 Annual Meeting by the Medical Schools Section and referred to the Board of Trustees, called on the American Medical Association to review various options to enhance the availability of transplantable organs. The Council responds with this report and with a companion report on mandated choice and presumed consent for organ donation. PMID:7887753

  11. Tiny tweaks, big changes: An alternative strategy to empower ethical culture of human research in anesthesia (A Taiwan Acta Anesthesiologica Taiwanica-Ethics Review Task Force Report).

    PubMed

    Luk, Hsiang-Ning; Ennever, John F; Day, Yuan-Ji; Wong, Chih-Shung; Sun, Wei-Zen

    2015-03-01

    For this guidance article, the Ethics Review Task Force (ERTF) of the Journal reviewed and discussed the ethics issues related to publication of human research in the field of anesthesia. ERTF first introduced international ethics principles and minimal requirements of reporting of ethics practices, followed by discussing the universal problems of publication ethics. ERTF then compared the accountability and methodology of several medical journals in assuring authors' ethics compliance. Using the Taiwan Institutional Review Board system as an example, ERTF expressed the importance of institutional review board registration and accreditation to assure human participant protection. ERTF presented four major human research misconducts in the field of anesthesia in recent years. ERTF finally proposed a flow-chart to guide journal peer reviewers and editors in ethics review during the editorial process in publishing. Examples of template languages applied in the Ethics statement section in the manuscript are expected to strengthen the ethics compliance of the authors and to set an ethical culture for all the stakeholders involved in human research. PMID:25868785

  12. Health physics ethics.

    PubMed

    Evdokimoff, Victor

    2004-02-01

    Ethics is defined in the New World Dictionary as ". . . moral principles governing appropriate conduct for an individual or group." The Health Physics Membership Directory contains 2 references for professional conduct for health physicists. The first is for members of the Health Physics Society. The second is for Certified Health Physicists. They are similar: A health physicist must always maintain the highest ethical standards whether beginning a career or having practiced for decades. A review of some key principles by example will hopefully demonstrate how to avoid ethical dilemmas for health physicists. PMID:14744062

  13. Ethics, Ethical Human Research and Human Research Ethics Committees

    ERIC Educational Resources Information Center

    Lindorff, Margaret

    2010-01-01

    Non-medical research involves the same issues of justice, beneficence, and respect for persons that apply to non-medical research. It also may involve risk of harm to participants, and conflicts of interest for researchers. It is therefore not possible to argue that such research should be exempt from ethical review. This paper argues that…

  14. Situating Ethics in Games Education

    ERIC Educational Resources Information Center

    Butler, Joy

    2013-01-01

    This paper posits that Inventing Games (IG), an aspect of the games curriculum based on principles of Teaching Games for Understanding (TGfU), opens up important spaces for teaching social and ethical understanding. Games have long been regarded as a site for moral development. For most teachers, however, ethical principles have been seen as…

  15. Teaching Ethics across the Public Relations Curriculum.

    ERIC Educational Resources Information Center

    Hutchison, Liese L.

    2002-01-01

    Suggests ways of incorporating ethics across the undergraduate public relations curriculum. Reviews current coverage of ethics in public relations principles, writing, cases, and textbooks. Suggests other methods that teachers can use to incorporate ethical pedagogical tools in all public relations courses in an effort to develop students' ethical…

  16. Professional Ethics in Education: A Neglected Issue.

    ERIC Educational Resources Information Center

    Annis, David B.

    This paper discusses the professional ethics of education and what it requires. After an introduction, the second section deals with the nature of professional ethics, clarifying a variety of ethical principles. The defining traits of an education profession and the ethical issues involved are discussed. The third section focuses on common…

  17. ACA Ethical Standards Casebook. Fifth Edition.

    ERIC Educational Resources Information Center

    Herlihy, Barbara; Corey, Gerald

    Perhaps the most basic function of a professional code of ethics is to educate members about sound ethical conduct. This casebook is designed to provide a foundation for analytic evaluation of the standards and guidance in applying ethical principles. It can be utilized in an ethics course or in a practicum or internship. The illustrative…

  18. The role of empirical Bayes methodology as a leading principle in modern medical statistics.

    PubMed

    van Houwelingen, Hans C

    2014-11-01

    This paper reviews and discusses the role of Empirical Bayes methodology in medical statistics in the last 50 years. It gives some background on the origin of the empirical Bayes approach and its link with the famous Stein estimator. The paper describes the application in four important areas in medical statistics: disease mapping, health care monitoring, meta-analysis, and multiple testing. It ends with a warning that the application of the outcome of an empirical Bayes analysis to the individual "subjects" is a delicate matter that should be handled with prudence and care. PMID:25205521

  19. Professional ethics.

    PubMed

    Downie, R S

    1986-06-01

    Downie comments on Sieghart's article, "Professions as the conscience of society" (Journal of Medical Ethics 1985 Sep; 11(3): 117-122). He charges that Sieghart is blurring empirical, conceptual, and moral claims when he contends that the professional relationship is unique in that "altruism is paramount and self-interest has no place." Downie holds that there is nothing to distinguish the doctor or lawyer from other occupations in terms of the criteria of self-interest and altruism. Likewise, these occupations have no nobler cause than those of the farmer or merchant. Because it is difficult, if not impossible, to provide necessary and sufficient criteria for defining a profession, the idea of a special "professional ethics" is a pernicious one that serves to protect professionals from public scrutiny. Sieghart briefly defends his earlier article, pointing out that it was addressed to practicing doctors and lawyers rather than to moral philosophers. PMID:3735360

  20. Principles and applications of polymerase chain reaction in medical diagnostic fields: a review

    PubMed Central

    Valones, Marcela Agne Alves; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; de Souza, Paulo Roberto Eleutério; de Albuquerque Tavares Carvalho, Alessandra; Crovela, Sergio

    2009-01-01

    Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances. PMID:24031310