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1

Medical ethics and Islam: principles and practice  

Microsoft Academic Search

A minimum level of cultural awareness is a necessary prerequisite for the delivery of care that is culturally sensitive. In this paper we simplify and highlight certain key teachings in Islamic medical ethics and explore their applications. We hope that the insights gained will aid clinicians to better understand their Muslim patients and deliver care that pays due respect to

A R Gatrad; A Sheikh

2001-01-01

2

Medical ethics and Islam: principles and practice  

Microsoft Academic Search

A minimum level of cultural awareness is a necessary prerequisite for the delivery of care that is culturally sensitive. In this paper we simplify and highlight certain key teachings in Islamic medical ethics and explore their applications. We hope that the insights gained will aid clinicians to better understand their Muslim pa- tients and deliver care that pays due respect

A R Gatrad; A Sheikh

2007-01-01

3

Shannon and Jake An Application of Medical Ethics Principles  

NSDL National Science Digital Library

This case was developed to teach first-year medical students the basics of medical ethics. It describes a situation in which a family physician is treating a teenage patient for a sexually transmitted disease. Based on information she gives him, he is concerned not only for her health and welfare, but also for the health and welfare of others. Students read the case and discuss the choices the doctor might make using the ethical principles of autonomy, beneficence, non-maleficence, and justice. Students then develop a rationale for the physician acting according to one of the ethical principles identified, and prepare a debate for the class supporting the rationale.

Knutson, Doug; Post, Doug M.

2006-01-01

4

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

PubMed Central

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".

Tsai, D F

1999-01-01

5

Medical ethics: four principles plus attention to scope.  

PubMed Central

The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work. Images p184-a p187-a

Gillon, R.

1994-01-01

6

The patient-centered medical home: an ethical analysis of principles and practice.  

PubMed

The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles. PMID:22829295

Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

2012-07-25

7

Principles of Biomedical Ethics  

PubMed Central

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.

Athar, Shahid

2012-01-01

8

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

PubMed

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

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

2013-01-01

9

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

PubMed Central

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.

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

2013-01-01

10

Education in medical ethics  

Microsoft Academic Search

Conclusions and Summary  While personal morality cannot be taught, ethical principles and their application to medical practice can be studied and\\u000a effectively learned.\\u000a \\u000a Since medical ethics is an essential component of practice of medicine, the study of ethics must be lifelong just like the\\u000a study of medicine.\\u000a \\u000a \\u000a \\u000a In addition to familiarity with ethical philosophical principles and an understanding of moral values

Joseph J. Sidorov

1993-01-01

11

Is Rorty's Neopragmatism the "Real" Foundation of Medical Ethics: a Search for Foundational Principles  

PubMed Central

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.

Branch, William T

2006-01-01

12

Elective non-therapeutic intensive care and the four principles of medical ethics.  

PubMed

The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for in situ organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented. PMID:23355225

Baumann, Antoine; Audibert, Gérard; Guibet Lafaye, Caroline; Lafaye, Caroline Guibet; Puybasset, Louis; Mertes, Paul-Michel; Claudot, Frédérique

2013-01-26

13

Principles of Biomedical Ethics  

Microsoft Academic Search

Medical knowledge and technology have advanced at a spectacular rate. This voyage of discovery has led to a wealth of ethical issues unimaginable to the original followers of the Hippocratic oath. Steeped in the history of philosophy and religion, the development of medical ethics has been an attempt to unravel and resolve the moral complexities and dilemmas that have faced

Tom L. Beauchamp; James F. Childless

1991-01-01

14

Business ethics, medical ethics and economic medicalization  

Microsoft Academic Search

This paper explores the ethical implications of economic medicalization: where non-medical problems are transformed into medical problems in order to achieve the objective of shareholder wealth maximization. After considering differences between business ethics and medical ethics, economic medicalization arising from corporate marketing strategies is detailed. Both direct-to-consumer and more traditional physician centred marketing methods are considered. In addition, the economic

Geoffrey Poitras

2009-01-01

15

Medical Ethics  

MedlinePLUS

... advance directives and resuscitation orders? Abortion: When does life begin? Is it ethical to terminate a pregnancy with a birth defect? Genetic and prenatal testing: What happens if you are a ... your family? Below you'll find some links about ethics in medicine.

16

Code of Ethics: Principles for Ethical Leadership  

PubMed Central

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.

Flite, Cathy A.; Harman, Laurinda B.

2013-01-01

17

Ethical Principles: Guiding the Use of Animals in Research.  

ERIC Educational Resources Information Center

|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)|

Morrison, Adrian R.

2003-01-01

18

Medical ethics as therapy.  

PubMed

In this paper, the author examines a style of teaching for a medical ethics course designed for medical students in their clinical years, a style that some believe conflicts with a commitment to analytic philosophy. The author discusses (1) why some find a conflict, (2) why there really is no conflict, and (3) the approach to medical ethics through narratives. The author will also argue that basing medical ethics on the use of narratives has problems and dangers not fully discussed in the literature. PMID:17036442

Zucker, A

2006-06-01

19

Ethical principles and recommendations for the medical management of differences of sex development (DSD)\\/intersex in children and adolescents  

Microsoft Academic Search

\\u000a Abstract  The medical management of differences of sex development (DSD)\\/intersex in early childhood has been criticized by patients’\\u000a advocates as well as bioethicists from an ethical point of view. Some call for a moratorium of any feminizing or masculinizing\\u000a operations before the age of consent except for medical emergencies. No exhaustive ethical guidelines have been published\\u000a until now. In particular, the

Claudia Wiesemann; Susanne Ude-Koeller; Gernot H. G. Sinnecker; Ute Thyen

2010-01-01

20

Principles of ethics: in managing a critical care unit.  

PubMed

Managing a critical care unit can present many challenges for those whose roles have been only as clinicians. The administrative position presents many new ethical issues that challenge both traditional medical and nursing ethics. The use of the basic ethical principles in these administrative issues may be less familiar. Ethical principles that guide the practice of professionals and their new position are explored and their use described in both positions. Traditional ethical issues include: utilitarianism, natural law, autonomy, beneficence, nonmaleficence, paternalism, justice, duty, rationing, informed consent, and withdrawing treatment. Conflicts in ethical issues are a natural consequence of the dual role of the professional. PMID:17242602

Thompson, Dan R

2007-02-01

21

Knowledge of medical ethics among Nigerian medical doctors  

PubMed Central

Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross-sectional questionnaire-based study involving 250 medical doctors of different levels was carried out. The questionnaire, apart from the bio-data, also sought information on undergraduate and postgraduate training in medical ethics, knowledge about the principles of biomedical ethics and the ethical dilemmas encountered in daily medical practice. Results: One hundred and ninety (190) respondents returned the filled questionnaire representing a response rate of 76%. One hundred and fifty-two respondents (80%) have had some sort of medical ethics education during their undergraduate level in the medical education. The median duration of formal training or exposure to medical ethics education was 3.00 hours (range: 0-15). One hundred and twenty-nine respondents have read at least once the code of medical ethics of the Medical and Dental Council of Nigeria while 127 (66.8%) have some general knowledge of the principles of biomedical ethics. The breakdown of the identified ethical dilemmas shows that discharge against medical advice was the most identified by the respondents (69.3%) followed by religious/cultural issues (56.6%) while confidentiality was recognized by 53.4%. Conclusion: The knowledge of medical ethics by Nigerian medical doctors is grossly inadequate. There is an urgent need for enhancement of the teaching of the discipline at both undergraduate and postgraduate levels in Nigeria.

Fadare, Joseph O.; Desalu, Olufemi O.; Jemilohun, Abiodun C.; Babatunde, Oluwole A.

2012-01-01

22

Medical ethics: some uses, abuses, and limitations.  

PubMed

A backlash against medical ethics may be developing because of a misunderstanding of its purpose and limitation. A primary role of medical ethics is to "structure" the disputed issues--i.e., by detailing the relevant principles and implications, analyzing the pivotal concepts, and focusing on the relevant facts. Medical ethics is limited by being unable to discriminate finely, so that a single line of action can seldom be determined by moral criteria alone. Underlying many criticisms of medical ethics is the failure to realize that medical ethics as such is not a reform movement or an effort to inspire moral behavior, that it is not and cannot be a specialist's body of esoteric knowledge, that it requires facts and conceptual analyses from other fields to do its work, and that value arguments can be carried farther than one generally expects. PMID:1057044

Clouser, K D

1975-08-21

23

How medical ethical principles are applied in treatment with artificial insemination by donors (AID) in Hunan, China: effective practice at the Reproductive and Genetic Hospital of CITIC-Xiangya  

PubMed Central

This paper investigates the efficiency of application of medical ethics principles in the practice of artificial insemination by donors (AID) in China, in a culture characterised by traditional ethical values and disapproval of AID. The paper presents the ethical approach to AID treatment as established by the Reproduction and Genetics Hospital of CITIC-Xiangya (CITIC Hunan-Yale Approach) in the central southern area of China against the social ethical background of China and describes its general features. The CITIC-Xiangya Approach facilitates the implementation of ethical relations between clinicians and patients participating in AID treatment procedures in Hunan-Yale.

Li, L; Lu, G

2005-01-01

24

Medical ethics: who decides what?  

Microsoft Academic Search

The FME symposium on teaching medical ethics takes up the issue of competence and responsibility in matters concerning bioethics (1). Foreseeably, the medical participants argue that physicians are prepared, or can be easily prepared, to handle all relevant aspects of medical ethics. The contrary position is sustained by the philosophically trained participants, who believe that physicians do not, in fact

M Kottow

1983-01-01

25

[Ethics and medical genetics].  

PubMed

Medical genetics may be distinguished from other medical specialities by its family dimension. Genetics raises many questions in the field of ethics concerning the potential applications in clinical medicine, in particular because of the technological evolution of human genetics in the medical field and the genetic research on the charting of the human genome. Human genetics involves filiation and questions the foundation of our society and the potential standardisation of human beings. The prescription of genetic tests is a tool for doctors but its use should be measured and carefully thought out according to the questions asked and the results expected. Examination of this issue within the context of the bioethics laws in France has made it possible to establish a framework for a certain number of practices so as to answer certain questions in human genetics. This article attempts to review the situation as it stands today with regard to the ethical issues raised by genetic tests, presymptomatic diagnosis, prenatal and pre-implantation diagnosis, and bio-collections. PMID:22924195

Lacombe, Didier

2012-06-01

26

Islamic medical ethics: a primer.  

PubMed

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

Padela, Aasim I

2007-03-01

27

Teaching and Learning Medical Ethics  

PubMed Central

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.

Tiberius, Richard G.

1981-01-01

28

Power and the teaching of medical ethics.  

PubMed Central

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.

Nicholas, B

1999-01-01

29

How Many Principles for Public Health Ethics?  

PubMed Central

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.

Coughlin, Steven S.

2009-01-01

30

Modeling Medical Ethics through Intelligent Agents  

NASA Astrophysics Data System (ADS)

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.

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

31

[Human dignity and medical ethics].  

PubMed

The concept of human dignity and the respect to it have issued from various sources--philosophical, religious and cultural. The text deals with the thinking of some philosophers (intrinsic dignity versus attributed dignity), with religious thoughts (explaining the dignity of man as being created in God's image) and discusses the important declarations, especially the Universal Declaration of Human Rights. This declaration (UN, 1948) recognizes, in consent with both--the best philosophical tradition and biblical faith, the inherent dignity and worth of every human being (person); it is the first principle and the inescapable grounding for all human rights. The term human dignity is hotly debated in the present bioethics arena; nevertheless it is the source of considerable and dangerous confusion as well. Some bioethicists deny implicitly or even explicitly the dignity of every human being (they conflate intrinsic and attributed dignity), and others proclaim that dignity is a useless concept. But the respect to human dignity is the cornerstone of all medical ethics--this discipline will be changed into ethical parody without it. It is therefore necessary to see the problems in the broader context and to stand firmly on the right side of the dispute: on the side of each and every patient. PMID:22132618

Munzarová, Marta

2011-01-01

32

Ethical Principles for the Hospitality Curriculum  

Microsoft Academic Search

A survey of 45 GMs of the largest hotels in several U.S. states found a strong perception that hotel-industry workers and managers do not always behave ethically. The GMs' estimates of the annual cost of ethical violations in their own hotels ranged from under $10,000 to over $500,000, with a mean exceeding $100,000. Given a list of 12 ethical principles,

Gary Vallen; Matt Casado

2000-01-01

33

The Teaching of Medical Ethics.  

National Technical Information Service (NTIS)

Major advances in the medical sciences enable the physician to prolong life, detect genetic defects in the embryo, and transplant organs. The physician is also becoming increasingly involved in the social, economic, legal, and ethical problems that affect...

R. M. Veatch W. Gaylin C. Morgan

1973-01-01

34

Ethics of the Electrified Mind: Defining Issues and Perspectives on the Principled Use of Brain Stimulation in Medical Research and Clinical Care.  

PubMed

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, transcranial magnetic stimulation and transcranial direct current stimulation. 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

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

2013-06-01

35

Ethics for Medical Educators: An Overview and Fallacies  

PubMed Central

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.

Singh, Arjun

2010-01-01

36

Ethics for medical educators: an overview and fallacies.  

PubMed

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

Singh, Arjun

2010-07-01

37

Quality in health care and ethical principles.  

PubMed

Quality in health care and ethical principles The last three decades have seen rapid changes in the way United States of America (USA) health care has been delivered, financed and regulated. Four major stakeholders have emerged in the health care debate: patients, providers, payers and public regulatory agencies. These groups do not agree on a definition of quality health care. This paper suggests five ethical principles - autonomy, justice, beneficence, non-maleficence, and prudence - be included in the framework of quality health care. A framework that outlines possible relationships among these ethical attributes and four major stakeholders is presented. PMID:11012797

Huycke, L; All, A C

2000-09-01

38

Kitchener's Principle Ethics: Implications for Counseling Practice and Research  

ERIC Educational Resources Information Center

|This extensive literature review examining the influence of K. S. Kitchener's (1984) introduction of principle ethics on counseling and psychology ethics notes the ultimate practicality of principle ethics. The authors maintain that although a strong influence of principle ethics in the area of counselor education emerges through the review,…

Urofsky, Robert I.; Engels, Dennis W.; Engebretson, Ken

2008-01-01

39

Kitchener's Principle Ethics: Implications for Counseling Practice and Research  

ERIC Educational Resources Information Center

This extensive literature review examining the influence of K. S. Kitchener's (1984) introduction of principle ethics on counseling and psychology ethics notes the ultimate practicality of principle ethics. The authors maintain that although a strong influence of principle ethics in the area of counselor education emerges through the review, there…

Urofsky, Robert I.; Engels, Dennis W.; Engebretson, Ken

2008-01-01

40

A Medical Ethics Assessment of the Case of Terri Schiavo  

ERIC Educational Resources Information Center

|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…

Preston, Tom; Kelly, Michael

2006-01-01

41

Medical ethics in the German Democratic Republic.  

PubMed

Medical ethics has been developing in the German Democratic Republic (GDR) since the 1970's on the basis of the traditional ethics of physicians and the socio-economic fundamentals of our socialist state. Medical care provided in the framework of Marxist-Leninist medical ethics is based on rationality and humanity. PMID:2809433

Luther, E

1989-06-01

42

The Ethics of Prescribing Medications to Older People  

Microsoft Academic Search

\\u000a The four principles of medical ethics – beneficence, nonmaleficence, autonomy, and justice – provide a pragmatic foundation\\u000a and steadying influence to guide prescribing in older people where the evidence base for efficacy is uncertain and concerns\\u000a regarding adverse drug reactions are protean. In most cases, the ethical principles are undermined not by intent, but more\\u000a likely by lack of knowledge,

David G. Le Couteur; Hal Kendig; Vasi Naganathan; Andrew J. McLachlan

43

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

PubMed Central

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.

2012-01-01

44

Methods and principles in biomedical ethics.  

PubMed

The four principles approach to medical ethics plus specification is used in this paper. Specification is defined as a process of reducing the indeterminateness of general norms to give them increased action guiding capacity, while retaining the moral commitments in the original norm. Since questions of method are central to the symposium, the paper begins with four observations about method in moral reasoning and case analysis. Three of the four scenarios are dealt with. It is concluded in the "standard" Jehovah's Witness case that having autonomously chosen the authority of his religious institution, a Jehovah's Witness has a reasonable basis on which to refuse a recommended blood transfusion. The author's view of the child of a Jehovah's Witness scenario is that it is morally required-not merely permitted-to overrule this parental refusal of treatment. It is argued in the selling kidneys for transplantation scenario that a fair system of regulating and monitoring would be better than the present system which the author believes to be a shameful failure. PMID:14519835

Beauchamp, T L

2003-10-01

45

A Survey of Medical Ethics Education in Iran Medical Faculties  

Microsoft Academic Search

Despite the progresses and attentions made to ethics education in Iran, little is known about the situation of undergraduate ethics education. Therefore, we undertook a study to assess the status of medical ethics education in medical faculties of Iran. Three questionnaires were sent to 32 state medical faculties. A reminding letter was sent to the cases with no response one

Fatemeh Shidfar; Saeedeh Sadeghi; Ahmad Kaviani

2007-01-01

46

Ethical Principles of Psychologists and Code of Conduct.  

ERIC Educational Resources Information Center

|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…

American Psychologist, 2002

2002-01-01

47

A moral principles framework for human resource management ethics  

Microsoft Academic Search

This paper argues that the analysis of ethical issues in human resource management is legitimate and important. It argues that the theory of ethical relativism should be rejected and that it is meaningful to search for universal moral principles. It then presents a comprehensive framework for making judgments about human resource management ethics that consists of five complementary moral principles

Paul L. Schumann

2001-01-01

48

Medical Students' Affirmation of Ethics Education  

ERIC Educational Resources Information Center

|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…

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

2009-01-01

49

Western medical ethics taught to junior medical students can cross cultural and linguistic boundaries  

Microsoft Academic Search

BACKGROUND: Little is known about teaching medical ethics across cultural and linguistic boundaries. This study examined two successive cohorts of first year medical students in a six year undergraduate MBBS program. METHODS: The objective was to investigate whether Arabic speaking students studying medicine in an Arabic country would be able to correctly identify some of the principles of Western medical

Valmae A Ypinazar; Stephen A Margolis

2004-01-01

50

[Ethics and prevention of medicalization].  

PubMed

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

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

2013-06-13

51

[Ethical principles in human scientific research].  

PubMed

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

Cruz-Coke, R

1994-07-01

52

[Ethical principles to investigate the human genome].  

PubMed

The scientific community is becoming aware that mankind has started to directly manipulate the mechanisms that transmit life and guide our species evolution. These facts are overflowing the traditional concepts about humanism and medical ethics, with an unpredictable scope. Presently we are conscious that there is an universal and biological order that rules life in our planet. At the molecular level there is an hereditary order and scientists have established the "central dogmas" of molecular biology and "genetic creed" of Mendelian theory in population genetics. The biotechnological revolution of the last decades is dismantling the normal processes of biological balance through the early detection and healing of defects, the manipulation of reproduction and the rupture of species boundaries with interspecies hybridization. All these issues open debates about the ethical limits of scientific research freedom. As a consequence, the dictation of genetic ethical codes has been proposed and statements that restrain genic therapy methods, genetic heritage manipulation and the patent right for DNA sequences, have been approved. The Valencia Statement (1990) on ethics about human genome tries to conciliate and establish a minimal consensus among scientists. However it seems that we are tearing down the frontiers that keep the sanctuary of biological order closed and damaging the twentieth century science dogmas. PMID:8303116

Cruz-Coke, R

1993-02-01

53

The Application of Ecological Principles in Establishing an Environmental Ethic.  

ERIC Educational Resources Information Center

|Examines four ecological principles and their misapplication in common models of environmental ethics. The principles include balance in nature, the fragility of nature, high diversity yielding high stability, and interdependence in nature. Also suggests an alternative way to incorporate each principle in a working environmental ethic. (AIM)|

Bicak, Charles J.

1997-01-01

54

The forms and limits of medical ethics.  

PubMed

As medical ethics has evolved over the past several decades, it has come to be regarded as a domain of applied ethics, that is, the application of a rationally based, philosophical theory to moral problems in health care. But an array of difficulties arise in the attempt to apply general moral theories or norms to concrete problems, difficulties that expose the incompleteness and indeterminacy of philosophical moral theory. The doubtful ability of applied ethics to be practically helpful has led to the development of two main competitors. One is the attempt to reprise and rehabilitate the tradition of moral casuistry, which focuses on the analysis of specific cases rather than on the defense and application of theories and norms. The second is the search for moral insight and guidance in narratives or stories. These alternatives suffer from some of the same difficulties that plague applied ethics, however. Another trend in medical ethics rejects the theoretical preoccupation of applied ethics in favour of contextualism--an insistence on situating moral problems in institutional and organizational structures and in social and cultural backgrounds. Social science investigations of medical ethics pay attention to the former, while feminist critiques of medical ethics are concerned with exposing and eradicating cultural biases against women. Contemporary work in medical ethics is diverse, but these manifold approaches hold out the promise of improving our understanding of morality as a truly practical enterprise. PMID:7801153

Hoffmaster, B

1994-11-01

55

A Student's Perspective on Medical Ethics Education.  

PubMed

Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student. PMID:23793349

Terndrup, Christopher

2013-12-01

56

Preferences for Key Ethical Principles that Guide Business School Students  

ERIC Educational Resources Information Center

|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…

Guyette, Roger; Piotrowski, Chris

2010-01-01

57

Preferences for Key Ethical Principles that Guide Business School Students  

ERIC Educational Resources Information Center

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…

Guyette, Roger; Piotrowski, Chris

2010-01-01

58

Canadian University Ethics Review: Cultural Complications Translating Principles into Practice  

ERIC Educational Resources Information Center

|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…

Tilley, Susan; Gormley, Louise

2007-01-01

59

Does pregnancy affect medical ethical decision making?  

PubMed Central

OBJECTIVE: We studied and compared the attitudes of pregnant women v new mothers in an attempt to confirm changing patterns of maternal response towards medical ethical decision making in critically ill or malformed neonates. DESIGN: Data were obtained by questionnaires divided into three sections: 1. sociodemographic; 2. Theoretical principles which might be utilised in the decision-making process; 3. Hypothetical case scenarios, each followed by possible treatment options. RESULTS: Pregnant women (n = 545) consistently requested less aggressive medical intervention for the hypothetical cases than did new mothers (n = 250) [Trisomy 18: 57% v 42%; p = 0.0004; Asphyxia: 75% v 63%; p = 0.0017; Down's syndrome 81% v 62%; p = 0.0001; LBW 85% v 75%; p = 0.004]. Significant differences were also observed in the responses to the theoretical principles, with pregnant women attributing less importance to preserving life at all cost, while being more concerned with physical and emotional pain and suffering, with financial cost, and with the infant's potential for future productivity.

Hammerman, C; Lavie, O; Kornbluth, E; Rabinson, J; Schimmel, M S; Eidelman, A I

1998-01-01

60

Rethinking medical ethics: a view from below.  

PubMed

In this paper, we argue that lack of access to the fruits of modern medicine and the science that informs it is an important and neglected topic within bioethics and medical ethics. This is especially clear to those working in what are now termed 'resource-poor settings'- to those working, in plain language, among populations living in dire poverty. We draw on our experience with infectious diseases in some of the poorest communities in the world to interrogate the central imperatives of bioethics and medical ethics. AIDS, tuberculosis, and malaria are the three leading infectious killers of adults in the world today. Because each disease is treatable with already available therapies, the lack of access to medical care is widely perceived in heavily disease-burdened areas as constituting an ethical and moral dilemma. In settings in which research on these diseases are conducted but there is little in the way of therapy, there is much talk of first world diagnostics and third world therapeutics. Here we call for the 'resocialising' of ethics. To resocialise medical ethics will involve using the socialising disciplines to contextualise fully ethical dilemmas in settings of poverty and, a related gambit, the systematic participation of the destitute sick. Clinical research across steep gradients also needs to be linked with the interventions that are demanded by the poor and otherwise marginalised. We conclude that medical ethics must grapple more persistently with the growing problem posed by the yawning 'outcome gap' between rich and poor. PMID:15086372

Farmer, Paul; Campos, Nicole Gastineau

2004-05-01

61

Buddhism and Medical Ethics: A Bibliographic Introduction  

Microsoft Academic Search

ABSTRACT ,This article provides an introduction to some contemporary issues in medical ethics and the literature which addresses them from a Buddhist perspective. The first part of the article discusses Buddhism,and medicine,and outlines some of the main issues in contemporary,medical ethics. In the rest of the paper three subjects are considered: i) moral personhood, ii) abortion, and iii) death, dying

James J. Hughes

1995-01-01

62

Time for a unified approach to medical ethics  

PubMed Central

A code of ethics is used by individuals to justify their actions within an environment. Medical professionals require a keen understanding of specific ethical codes due to the potential consequences of their actions. Over the past thirty years there has been an increase in the scope and depth of ethics instruction in the medical profession; however the teaching of these codes is still highly variable. This inconsistency in implementation is problematic both for the medical practitioner and for the patient; without standardized training, neither party can be assured of the practitioner's overall depth of knowledge. Within the field of ethics certain principles have reached a consensus of importance. Incorporation of these concepts in meaningful ways via a consistent curriculum would provide students with an appropriate skill set for navigating their ethical environment. Moreover, this curriculum should also be extended to residents and professionals who may have missed formal ethical training. This would provide a consistent framework of knowledge for practitioners, creating a basis for clear judgment of complex issues.

Lakhan, Shaheen E; Hamlat, Elissa; McNamee, Turi; Laird, Cyndi

2009-01-01

63

Is a moral consensus in medical ethics possible?  

PubMed Central

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.

Mitchell, B.

1976-01-01

64

Ethics and maternity care: from principles to practice.  

PubMed

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

Lothian, Judith A

2009-01-01

65

Nurse prescribing ethics and medical marketing.  

PubMed

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

Adams, J

66

Changes in undergraduate attitudes toward medical ethics.  

PubMed Central

To detect any change in medical students' attitudes toward medical ethics, students from the same class were given a questionnaire on their first day of medical school and again near the end of their fourth year of study. The results showed a strong shift away from the students' initial expectations that they would rely on specialists or scholarly sources in the future; the need for a medical ethics course in the curriculum, while still felt, was less important to them by the fourth year. The reasons for these changes were not apparent, for the students' levels of knowledge and perceptions of the role of ethics in medicine in the first and fourth years did not differ. It is recommended that medical school faculty actively reinforce the initially positive attitudes of students during clinical supervision.

Tiberius, R. G.; Cleave-Hogg, D.

1984-01-01

67

Changes in undergraduate attitudes toward medical ethics.  

PubMed

To detect any change in medical students' attitudes toward medical ethics, students from the same class were given a questionnaire on their first day of medical school and again near the end of their fourth year of study. The results showed a strong shift away from the students' initial expectations that they would rely on specialists or scholarly sources in the future; the need for a medical ethics course in the curriculum, while still felt, was less important to them by the fourth year. The reasons for these changes were not apparent, for the students' levels of knowledge and perceptions of the role of ethics in medicine in the first and fourth years did not differ. It is recommended that medical school faculty actively reinforce the initially positive attitudes of students during clinical supervision. PMID:6697281

Tiberius, R G; Cleave-Hogg, D

1984-03-15

68

A model for teaching medical ethics.  

PubMed Central

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.

Welbourn, R B

1985-01-01

69

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

PubMed

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

Juki?, Vlado

2012-10-01

70

Ethics in medical information and advertising  

Microsoft Academic Search

This article presents findings and recommendations of an international conference held in Cairo, Egypt in 2003 concerning issues of ethical practice in how information is provided to and by medical practitioners. Professional advertising to practitioners and the public is necessary, but should exclude misrepresentation of qualifications, resources, and authorship of research papers. Medical institutions are responsible for how staff members

G. I. Serour; B. M. Dickens

2004-01-01

71

Medical Schools, Clinical Research, and Ethical Leadership  

ERIC Educational Resources Information Center

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)

Makarushka, Julia L.; Lally, John J.

1974-01-01

72

Intragastric Balloon: Ethics, Medical Need and Cosmetics  

Microsoft Academic Search

The development of the intragastic balloon as a safe, noninvasive, alternative method to weight reduction raises all the ethical questions routinely faced by practitioners of other forms of cosmetic surgery. In the case of the morbidly, severely or merely obese, the surgeon is faced with a medical decision in a situation defined by medical parameters. The case of the overweight

Katerina Kotzampassi; Anne D. Shrewsbury

2008-01-01

73

The teaching of medical ethics to medical students.  

PubMed

Teaching medical ethics to medical students in a pluralistic society is a challenging task. Teachers of ethics have obligations not just to teach the subject matter but to help create an academic environment in which well motivated students have reinforcement of their inherent good qualities. Emphasis should be placed on the ethical aspects of daily medical practice and not just on the dramatic dilemmas raised by modern technology. Interdisciplinary teaching should be encouraged and teaching should span the entire duration of medical studies. Attention should be paid particularly to ethical problems faced by the students themselves, preferably at the time when the problems are most on the students' minds. A high level of academic demands, including critical examination of students' progress is recommended. Finally, personal humility on the part of teachers can help set a good example for students to follow. PMID:7861430

Glick, S M

1994-12-01

74

Human Rights, Ethical Principles, and Standards in Forensic Psychology  

Microsoft Academic Search

Human rights create a protective zone around persons and allow them the opportunity to further their valued personal projects without interference from others. This article considers the relationship between human rights and the general ethical principles and standards contained in the American Psychological Association's (APA's) code of ethics as applied to the forensic domain. First, it analyzes the concept of

Tony Ward; Theresa Gannon; Jim Vess

2009-01-01

75

Principles and Ethics for Elementary and Junior High School Teachers  

ERIC Educational Resources Information Center

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…

Howard, Kiffany

2010-01-01

76

Environmental ethics in Islam: principles, violations, and future perspectives  

Microsoft Academic Search

The aggressive manipulation of the natural resources in Kuwait and the destruction of the southern Arab marshes in Iraq, are two recent environmental disasters in the Arabian Gulf region. This paper elaborates some important principles of environmental ethics in Islam and shows some examples for which development of new Islamic thoughts in environmental ethics seems to be essential. As there

2008-01-01

77

The use of narrative in Jewish medical ethics.  

PubMed

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

Jotkowitz, Alan

2013-09-01

78

Foundations in the Law: Classic Cases in Medical Ethics.  

National Technical Information Service (NTIS)

The ethics of a people, as demonstrated through public policy, are generally thought to inform that people's legal system and its decisions. The converse is also true: decisions within a legal system inform, or impact, ethics -specifically medical ethics ...

A. R. Burton K. W. Zucker M. J. Boyle T. L. Allen V. S. Smyth

2007-01-01

79

Medical Ethics, Bioethics and Research Ethics Education Perspectives in South East Europe in Graduate Medical Education.  

PubMed

Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours. PMID:23436144

Mijaljica, Goran

2013-02-23

80

Human rights, ethical principles, and standards in forensic psychology.  

PubMed

Human rights create a protective zone around persons and allow them the opportunity to further their valued personal projects without interference from others. This article considers the relationship between human rights and the general ethical principles and standards contained in the American Psychological Association's (APA's) code of ethics as applied to the forensic domain. First, it analyzes the concept of human rights, their structure, and their justification. Second, it briefly describes the APA's most recent code of ethics and the principles and standards that compose it. Third, it concludes by explicitly examining the relationship between the present human rights model and the APA's code, demonstrating how it is able to provide an additional ethical resource for forensic practitioners in their clinical work and so deepen their ethical sensibilities and decision making. Finally, the article presents a case study and discusses the human rights issues confronting practitioners inherent in such situations. PMID:18268080

Ward, Tony; Gannon, Theresa; Vess, Jim

2008-02-11

81

The teaching of medical ethics at Southampton University Medical School.  

PubMed Central

For centuries medical schools in Britain and elsewhere had a fairly static curriculum based on what might be called the 'three Rs' of medicine, and consequently had to make room for new subjects as the need arose in a fashion which was sometimes makeshift. However, Southampton University has only had a medical school for six years, and therefore their course on medical ethics and legal medicine was carefully integrated into the curriculum after some preliminary experiments carried out by a subcommittee which is continually reviewing the situation. Medical ethics has now a definite place in the fourth year, preceded by an introduction to ethical problems encountered in medicine in the first year. Not only do members of the medical faculty participate in this teaching but also members of the faculties of law and the arts.

Dennis, K J; Hall, M R

1977-01-01

82

Jewish medical ethics--a brief overview.  

PubMed

Jewish contributions to medicine and medical ethics are outlined briefly by the Chief Rabbi of the British Commonwealth. Respect for the dignity and sanctity of human life, and a duty to preserve health, are grounded in biblical and legal traditions and are the basis of contemporary Jewish responses to such issues as abortion, contraception, euthanasia, and organ transplantation. Jewish as well as Christian and secular moral specialists should be included in decisions about applications of biomedical technologies that have profound implications for human well-being. Jakobovits concludes by advocating formal training in medical ethics for physicians and other health care professionals. PMID:6576175

Jakobovits, I

1983-06-01

83

Principles of Ethical Practice: Cases for Illustration and Dialog  

ERIC Educational Resources Information Center

In July 2007, a revised version of the Council for Learning Disabilities' principles of ethical practice was approved by CLD's Board of Trustees. Subsequently, the new standards were published in the January 8 issue of LD Forum. Using a case study approach, this article highlights the application of these principles to situations confronted by…

Skinner, Michael E.; Gurganus, Susan P.; Watson, Silvana M. R.

2009-01-01

84

Medical ethics and education for social responsibility.  

PubMed

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

Roemer, M I

85

Medical ethics and education for social responsibility.  

PubMed Central

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.

Roemer, M. I.

1980-01-01

86

Jewish medical ethics - a brief overview  

PubMed Central

This paper outlines the traditional Jewish approach to medical ethics, as perceived by the Chief Rabbi of the British Commonwealth, himself an academic specialist in this field. It is based on a `St Paul's Lecture' given to the London Diocesan Council for Christian Jewish understanding.

Jakobovits, Immanuel

1983-01-01

87

Medically assisted reproduction and ethical challenges  

Microsoft Academic Search

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

Helena. Kaeaeriaeinen; Gerry Evers-Kiebooms; Domenico Coviello

2005-01-01

88

Nurse educators and professional ethics--ethical principles and their implementation from nurse educators' perspectives.  

PubMed

This study describes nurse educators' knowledge of the ethical principles of professional codes of ethics and educators' assessment of the implementation of principles of fairness and human respect. Data for this study was collected from nurse educators in Finland. The data was analyzed by SPSS (15.0) for Windows. A total of 342 nurse educators participated. The response rate was 46%. Nurse educators knew well the ethical principles of professional codes governing their work. Older and more experienced educators knew the principles better than younger and less experienced. According to the educators the principle of fairness was implemented the best whereas fair treatment of nurse educators and respect for educators' opinions in the society were implemented the weakest. Educators who knew the principles well assessed themselves to act in a fairer way and to respect other persons' opinions in a better way than educators who knew these principles less well. They also felt themselves to be better treated than educators having less knowledge of the principles. These findings can be utilized to develop nurse educators' ethics education. Further research should focus on students', colleagues' and superiors' assessments of nurse educators' ethical knowledge base to gain comparative data on the phenomenon. PMID:22154952

Salminen, Leena; Metsämäki, Riikka; Numminen, Olivia H; Leino-Kilpi, Helena

2011-12-10

89

Ethics  

Cancer.gov

The U.S. Department of Health and Human Services Office of Human Research Protection (OHRP) has mandated that all research sites outside the United States that participate in research funded by the U.S. Government must file documentation certifying that each research site observes the Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and has an independent ethics committee. Sites participating in trials sponsored by the U.S. National Cancer Institute (NCI) must also undergo regular on-site audits.

90

Against the magnanimous in medical ethics.  

PubMed Central

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.

Kottow, M H

1990-01-01

91

Ethics and the medical uses of radiation  

SciTech Connect

The basis of ethical practice for the medical community in general and for nuclear medicine technology in particular is described as follows: 1) Know and use current guidelines for safe work procedures; 2) Establish and maintain a quality assurance program for equipment and radiopharmaceuticals; 3) Develop work habits incorporating the philosophy of the ALARA concept (radiation dose as low as reasonably achievable); 4) Establish and use protocols for routine procedures; 5) Make exceptions to accepted practices when benefit vs risk warrants these exceptions; 6) Make periodic audits to determine if ethical standards are being applied. (JMT)

Hibbard, W.M.

1982-06-01

92

The ethics of reality medical television.  

PubMed

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

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

2013-01-01

93

[Publicity, ethics and medical deontology].  

PubMed

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

Noterman, J

94

Casuistry in medical ethics: Rehabilitated, or repeat offender?  

Microsoft Academic Search

For a number of reasons, casuistry has come into vogue in medical ethics. Despite the frequency with which it is avowed, the application of casuistry to issues in medical ethics has been given virtually no systematic defense in the ethics literature. That may be for good reason, since a close examination reveals that casuistry delivers much less than its advocates

Tom Tomlinson

1994-01-01

95

Cost-benefit analysis and medical ethics.  

PubMed Central

The issue of assessing priorities is one that has become the subject of much debate in the National Health Service particularly in the wake of various documents on priorities from central Government. It has become even more so with the prospect of real cuts in expenditure. Economists claim that their science, or perhaps more accurately art can assist in determining not only how best to achieve various ends but also whether and to what extent competing objectives should be pursued. Such choices cannot be made in the absence of some ethical considerations and it is important that health service decision makers (and in particular the medical profession) are aware if the relationship between economics (and especially cost-benefit analysis) and medical ethics.

Mooney, G H

1980-01-01

96

How virtue ethics informs medical professionalism.  

PubMed

We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education-first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and third, avoiding temptations to dismiss moral distress as a mere "hidden curriculum" problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness. PMID:23138499

McCammon, Susan D; Brody, Howard

2012-12-01

97

Ethical issues related to medical expert testimony.  

PubMed

The obstetrician-gynecologist who provides expert witness testimony is recognized as an important participant in the medical liability system. He or she must define a standard of care and opine whether the standard has been breached and whether any perceived injury was caused by the breach. The American College of Obstetricians and Gynecologists (ACOG) ethical guidelines insist that the testimony be objective (free from intentioned distortion) and that the witness not assume an advocacy or partisan role. The ethical and professional boundaries of appropriate expert testimony as delineated by ACOG are more restrictive than the legal boundaries. Members of ACOG should be held to more restrictive ACOG guidelines and egregious testimony condemned by ACOG. Prospective peer review, increased judicial review, and testimony banks are other examples of methods to improve the quality of expert witness testimony. Alternatives to litigation for medical liability disputes and further tort reform might also make the system fairer and more sustainable. PMID:16260525

Hammond, Charles B; Schwartz, Peter A

2005-11-01

98

'Medical ethics'--an alternative approach.  

PubMed Central

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.

Haldane, J J

1986-01-01

99

Medical ethics--a Christian view.  

PubMed Central

All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this.

Habgood, J S

1985-01-01

100

Ethical problems in medically assisted procreation  

Microsoft Academic Search

The risks associated with the techniques of medically assisted procreation (MAP) rapidly became well-known, and in such a short space of time that no biomedical domain remained untouched by the great deal of thinking and the expression of a multitude of opinions it provoked. MAP is evolving between two poles: quality\\/misuse (even violation) and evidence\\/fantasy. The ethics will be evoked

Marc Germond

1998-01-01

101

Teaching old dogs new tricks—a personal perspective on a decade of efforts by a clinical ethics committee to promote awareness of medical ethics  

Microsoft Academic Search

To incorporate medical ethics into clinical practice, it must first be understood and valued by health care professionals. The recognition of this principle led to an expanding and continuing educational effort by the ethics committee of the Vancouver General Hospital. This paper reviews this venture, including some pitfalls and failures, as well as successes. Although we began with consultants, it

Martin G Tweeddale

2001-01-01

102

Thoughts on John Dewey's "Ethical Principles Underlying Education."  

ERIC Educational Resources Information Center

Examines Dewey's claim that moral education refers to both the conduct of education (a morally defensible form of education) and the product of education (a moral citizenry) as expressed in his essay "Ethical Principles Underlying Education." Maintains that Dewey did not consider adequately the need for specifically moral criteria for behavior.…

Noddings, Nel

1998-01-01

103

Some principles of Islamic ethics as found in Harrisian philosophy.  

PubMed

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

Aksoy, Sahin

2010-04-01

104

Ethics and Information Technology: Some Principles To Guide Students.  

ERIC Educational Resources Information Center

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…

Bodi, Sonia

1998-01-01

105

Ethical and medical dilemmas of space tourism  

NASA Astrophysics Data System (ADS)

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.

Marsh, Melinda

106

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

PubMed

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

Jotkowitz, A

2008-12-01

107

Medical confidentiality versus disclosure: Ethical and legal dilemmas.  

PubMed

A case is described of a fifty year old single man who made disclosures about criminal sexual practices during a psychiatric assessment. In common practice with other professional men, a doctor is under a duty not to disclose, without the consent of his patient, information which he has gained in his professional capacity other than in exceptional circumstances. We discuss the ethical and legal considerations surrounding issues of medical confidentiality and the dilemma that sometimes face clinicians, when they feel obliged, in the public interest, to disclose information they have gained in confidence. Breach of confidences can have deleterious consequences; particularly for the doctor-patient relationship, but failure to disclose in some situations could have serious implications for the well-being of the wider society. Doctors should be aware of the basic principles of confidentiality and the ethical and legal framework around which they are built. PMID:19135004

Agyapong, V I O; Kirrane, R; Bangaru, R

2008-10-11

108

Medically assisted reproduction and ethical challenges  

SciTech Connect

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.

Kaeaeriaeinen, Helena [Department of Medical Genetics, University of Turku, Kiinamyllynkatu 10, 20520 Turku (Finland) and Department of Clinical Genetics, Turku University Hospital, Turku (Finland)]. E-mail: helena.kaariainen@utu.fi; Evers-Kiebooms, Gerry [Department of Human Genetics, University of Leuven (Belgium); Coviello, Domenico [Laboratory of Medical Genetics, ICP, University Hospital of Milan (Italy)

2005-09-01

109

Not just autonomy--the principles of American biomedical ethics.  

PubMed Central

The Principles of Biomedical Ethics by Tom L Beauchamp and James F Childress which is now in its fourth edition has had a great influence on the development of bioethics through its exposition of a theory based on the four principles: respect for autonomy; non-maleficence; beneficence, and justice (1). The theory is developed as a common-morality theory, and the present paper attempts to show how this approach, starting from American common-morality, leads to an underdevelopment of beneficence and justice, and that the methods offered for specification and balancing of principles are inadequate.

Holm, S

1995-01-01

110

Medical students' evaluations of different levels of medical ethics teaching: implications for curricula.  

PubMed

Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education. PMID:3626902

Howe, K R

1987-07-01

111

[Emerging problems of medical ethics in Russia: medical practice and research].  

PubMed

The problem of maintenance of integrity of medical profession is rarely discussed in Russia. Meanwhile the following pressing challenges emerge within the medical community in this country: tolerant attitude to violations of ethical principles and falsification in research, incompetence and deceit in practical work, wide penetration of alternative medicine and witchery into everyday medical practice, involvement of physicians in advertising and marketing of drugs, even direct selling of them by medical doctors. Medical community should urgently respond to these challenges and develop mechanisms of internal control. This can be accomplished within the framework of associations of physicians and medical professional groups. Without solution of the above problems Russian medicine would never occupy appropriate high position in the society. PMID:12494154

Vlasov, V V

2002-01-01

112

Imparting Medical Ethics: The Role of Mentorship in Clinical Training  

ERIC Educational Resources Information Center

|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…

Rose, Gail L.; Rukstalis, Margaret R.

2008-01-01

113

Islamic medical ethics in the 20th century  

Microsoft Academic Search

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

V Rispler-Chaim

1989-01-01

114

An Analysis of Student Choices in Medical Ethical Dilemmas.  

ERIC Educational Resources Information Center

|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…

Woloshin, Phyllis Lerman

115

An Analysis of Student Choices in Medical Ethical Dilemmas.  

ERIC Educational Resources Information Center

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…

Woloshin, Phyllis Lerman

116

HIV infection and AIDS: the ethics of medical confidentiality  

Microsoft Academic Search

An Institute of Medical Ethics working party argues that an ethically desirable relationship of mutual empowerment between patient and clinician is more likely to be achieved if patients understand the ground rules of medical confidentiality. It identifies and illustrates ambiguities in the General Medical Council's guidance on AIDS and confidentiality, and relates this to the practice of different doctors and

K M Boyd

1992-01-01

117

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

PubMed Central

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.

Thornton, T

2006-01-01

118

An international survey of medical ethics curricula in Asia.  

PubMed Central

SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries. OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools. DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand. PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country. MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties. RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics. CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.

Miyasaka, M; Akabayashi, A; Kai, I; Ohi, G

1999-01-01

119

Students' attitudes to ethics in the medical school curriculum.  

PubMed Central

A survey of 106 medical students assessing their interest in and attitudes to medical ethics in the curriculum is reported by the authors. Results indicate that 64 per cent of the students rated the importance of medical ethics to good medical care as high or critical and 66 per cent desired to learn more about the topic. However, in reports of patient encounters identifying ethical issues, less than six per cent of the students reported a frequency of more than one such patient encounter per week. The students also demonstrated a greater awareness of more obvious ethical issues than of more subtle, less publicised issues. When asked how medical ethics should be taught, the students clearly affirmed a desire for an integrated exposure to the subject throughout the medical curriculum. Possible implications of these findings for medical education are discussed.

Shelp, E E; Russell, M L; Grose, N P

1981-01-01

120

Medicine, Ethics, and the Elderly.  

ERIC Educational Resources Information Center

Medical ethical problems involving the elderly elucidate the relation between broader social views of aging and ethical principles basic to medicine. Three clinical situations are described and alternative principles of medical ethics are discussed as a basis for resolution of ethical problems in the health care of the elderly. (Author)

Gadow, Sally

1980-01-01

121

Review of the teaching of medical ethics in London medical schools.  

PubMed Central

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. Stronger guidelines are necessary to ensure appropriate ethical training in London medical schools.

Burling, S J; Lumley, J S; McCarthy, L S; Mytton, J A; Nolan, J A; Sissou, P; Williams, D G; Wright, L J

1990-01-01

122

Cultural context in medical ethics: lessons from Japan  

Microsoft Academic Search

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

Tia Powell

2006-01-01

123

Advanced medical ethics symposia for fifth-year students.  

PubMed Central

Case-based, multidisciplinary seminars provided a vehicle for clinicians, philosophers and students to debate current problems in medical ethics in a manner which ensured maximum learning and interest for all participants. Prior training in philosophical medical ethics was an essential prerequisite, giving students the knowledge and skills to take part in the discussions at an appropriate level of sophistication.

Grant, V J

1989-01-01

124

Against medical ethics: opening the can of worms.  

PubMed

In a controversial paper, David Seedhouse argues that medical ethics is not and cannot be a distinct discipline with it own field of study. He derives this claim from a characterization of ethics, which he states but does not defend. He claims further that the project of medical ethics as it exists and of moral philosophy do not overlap. I show that Seedhouse's views on ethics have wide implications which he does not declare, and in the light of this argue that Seedhouse owes us a defence of his characterization of ethics. Further, I show that his characterization of ethics, which he uses to attack medical ethics, is a committed position within moral philosophy. As a consequence of this, it does not allow the relation between moral philosophy and medical ethics to be discussed without prejudice to its outcome. Finally, I explore the relation between Seedhouse's position and naturalism, and its implications for medical epistemology. I argue that this shows us that Seedhouse's position, if it can be defended, is likely to lead to a fruitful and important line of inquiry which reconnects philosophy and medical ethics. PMID:9549676

Cassell, J

1998-02-01

125

Against medical ethics: opening the can of worms.  

PubMed Central

In a controversial paper, David Seedhouse argues that medical ethics is not and cannot be a distinct discipline with it own field of study. He derives this claim from a characterization of ethics, which he states but does not defend. He claims further that the project of medical ethics as it exists and of moral philosophy do not overlap. I show that Seedhouse's views on ethics have wide implications which he does not declare, and in the light of this argue that Seedhouse owes us a defence of his characterization of ethics. Further, I show that his characterization of ethics, which he uses to attack medical ethics, is a committed position within moral philosophy. As a consequence of this, it does not allow the relation between moral philosophy and medical ethics to be discussed without prejudice to its outcome. Finally, I explore the relation between Seedhouse's position and naturalism, and its implications for medical epistemology. I argue that this shows us that Seedhouse's position, if it can be defended, is likely to lead to a fruitful and important line of inquiry which reconnects philosophy and medical ethics.

Cassell, J

1998-01-01

126

The ethical implications of prospective payment and corporate medical practice: A research agenda  

Microsoft Academic Search

The major trends in the growth of prospective payment and the corporatization of medical practice in the United States are examined. In particular, the ethical implications of these changes in the context of the multiple system goals of access, cost containment, and quality are considered. Considerable concern is being expressed that with the dominant emphasis on cost containment, the principles

Lu Ann Aday

1987-01-01

127

Transplant ethics under scrutiny - responsibilities of all medical professionals  

PubMed Central

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.

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

2013-01-01

128

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

PubMed

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

Duquenoy, Penny; George, Carlisle; Solomonides, Anthony

2008-07-22

129

Ethical framework for medication discontinuation in nursing home residents with limited life expectancy.  

PubMed

A recent editorial by health economist Victor Fuchs summarized the current challenges with health care delivery in this way: “Most physicians want to deliver ‘appropriate’ care. Most want to practice ‘ethically’, but it is difficult to know what is ‘appropriate’ and what is ‘ethical’. This characterization is particularly true for medication use and deprescribing in elderly NH residents with limited life expectancy. Medical ethics sets 4 key principles (beneficence, nonmaleficence, patient autonomy, and justice) to guide practice. However, decisional conflicts will continue between providers and patients, and physicians will continue to struggle with the dilemma of balancing the primacy of patient welfare, values, and beliefs against the desire for promising, but often minimally beneficial and harmful, medications that threaten limited clinical resources. Despite these challenges, physicians should be able to perform systematic medication reviews and monitor discontinuation trials in their NH patients for whom this is consistent with their goals of care. PMID:22500542

Tjia, Jennifer; Givens, Jane

2012-02-23

130

Reflecting on the ethical administration of computerized medical records  

NASA Astrophysics Data System (ADS)

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.

Collmann, Jeff R.

1995-05-01

131

A Framework for Understanding and Applying Ethical Principles in Network and Security Research  

NASA Astrophysics Data System (ADS)

Current information and communications technology poses a variety of ethical challenges for researchers. In this paper, we present an intellectual framework for understanding and applying ethical principles in networking and security research rooted in the guidance suggested by an ongoing Department of Homeland Security working group on ethics. By providing this prototype ethical impact assessment, we seek to encourage community feedback on the working group's nascent efforts and spur researchers to concretely evaluate the ethical impact of their work.

Kenneally, Erin; Bailey, Michael; Maughan, Douglas

132

Empirical investigation of the ethical reasoning of physicians and molecular biologists - the importance of the four principles of biomedical ethics  

PubMed Central

Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice. Conclusion This study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting.

Ebbesen, Mette; Pedersen, Birthe D

2007-01-01

133

The ethics and science of medicating children.  

PubMed

Prescriptions for psychiatric drugs to children and adolescents have skyrocketed in the past 10 years. This article presents evidence that the superior effectiveness of stimulants and antidepressants is largely a presumption based on an empirical house of cards, driven by an industry that has no conscience about the implications of its ever growing, and disturbingly younger, list of consumers. Recognizing that most mental health professionals do not have the time, and sometimes feel ill-equipped to explore the controversy regarding pharmacological treatment of children, this article discusses the four fatal flaws of drug studies to enable critical examination of research addressing the drugging of children. The four flaws are illustrated by the Emslie studies of Prozac and children, which offer not only a strident example of marketing masquerading as science, but also, given the recent FDA approval of Prozac for children, a brutal reminder of the danger inherent in not knowing how to distinguish science from science fiction. The authors argue that an ethical path requires the challenge of the automatic medical response to medicate children, with an accompanying demand for untainted science and balanced information to inform critical decisions by child caretakers. PMID:15706694

Sparks, Jacqueline A; Duncan, Barry L

2004-01-01

134

In search of an ethic of medical librarianship.  

PubMed Central

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.

Crawford, H

1978-01-01

135

It's ethical, but is it legal? Teaching ethics and law in the medical school curriculum.  

PubMed

While Western medical ethics has ancient roots in the teachings of Hippocrates, its standing in the undergraduate medical curriculum is a distinctly modern development. Today, all of the 127 accredited U.S. medical schools offer formal biomedical ethics instruction, and nearly all offer instruction in the related discipline of health law. This article describes how biomedical ethics and health law are taught at the University of Iowa College of Medicine, one of 12 medical schools that offers separate required courses in both ethics and law. Often ethics and law overlap; often, to act ethically is to act legally. But medical students and practicing physicians also regularly confront dilemmas that pose the question, "It's ethical, but is it legal?" This article discusses the goals, methods, and core themes of teaching issues at the intersection of medicine, ethics, and law, and how the approach to this instruction is designed to offer students a tool kit to begin to deal effectively with these complex issues in professional life. Anat Rec (New Anat) 265:5-9, 2001. PMID:11241205

Olick, R S

2001-02-01

136

[Complementary medicine--Jewish medical ethics].  

PubMed

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

Katz, Yisrae; Schiff, Elad

2011-08-01

137

A two-decade Review of Medical Ethics in Iran  

Microsoft Academic Search

The growing developments in science and technology have raised ethical challenges which should practically be addressed by scientists, regulatory bodies and policy makers. Likewise, challenging issues of medical ethics have also drawn a great deal of academic attention in Iran. In other words, recent decades have been an occasion of considerable development for contemporary bioethics in Iran. At first, the

F Zahedi; SH Emami Razavi; B Larijani

138

The Physical Principles of Medical Imaging  

NSDL National Science Digital Library

This web site contains an online version of "The Physical Principles of Medical Imaging" textbook with links to each chapter from the book or an on-line module. The textbook covers topics on the basic physics of radiation as well as the details of specific imaging methods. Links to other online curricular resources and learning modules are also available.

Sprawls, Perry

2010-06-08

139

The narrative approach in teaching medical ethics: the Turkish experience.  

PubMed

The Deontology and Medical History Departments in Turkey teach Medical Ethics Education. These departments were first established by medical historians and for the time being the staff is primarily interested in deontology. The Department of Deontology in the Faculty of Medicine at Ankara University is the first department in Turkey to teach medical ethics. In 1974, issues including medical ethics were included in the current curriculum for the Medical Deontology and Medical History Course, but without changing the title of the course. Since then, different scholars have used different teaching methods. In this paper, a very new teaching strategy and technique used by the author will be discussed. In Turkey, the main resources being used as teaching materials in medical ethics are books and periodicals of mainly Western European and North American origin. Cultural, religious, and traditional characteristics of Turkey differ a great deal, so these texts need to be modified. This modification is hard to accomplish, because discourse on authentic values and value systems is inadequate. Also, this way of thinking about values is alien to most medical students. A narrative approach in teaching medical ethics aims to introduce local values that affect medical practice to first year medical students of the Faculty of Medicine at Ankara University, by searching for those values in literary texts and case histories. Besides introducing local values, some of our main goals are to encourage students to develop a sensitivity towards ethical issues and to teach them the methodology of ethical thinking. This is still a pilot study that covers only four hours of a thirty-hour program (two-hour sessions, twice in one semester), but some conclusions can be drawn. In this presentation, some information about the content and the structure of the course will be given, and the positive and negative results about the narrative approach will be discussed, arising from our limited local experience. PMID:11143879

Oguz, N Y

2000-01-01

140

Poverty and maternal mortality in Nigeria: towards a more viable ethics of modern medical practice  

PubMed Central

Poverty is often identified as a major barrier to human development. It is also a powerful brake on accelerated progress toward the Millennium Development Goals. Poverty is also a major cause of maternal mortality, as it prevents many women from getting proper and adequate medical attention due to their inability to afford good antenatal care. This Paper thus examines poverty as a threat to human existence, particularly women's health. It highlights the causes of maternal deaths in Nigeria by questioning the practice of medicine in this country, which falls short of the ethical principle of showing care. Since high levels of poverty limit access to quality health care and consequently human development, this paper suggests ways of reducing maternal mortality in Nigeria. It emphasizes the importance of care ethics, an ethical orientation that seeks to rectify the deficiencies of medical practice in Nigeria, notably the problem of poor reproductive health services. Care ethics as an ethical orientation, attends to the important aspects of our shared lives. It portrays the moral agent (in this context the physician) as a self who is embedded in webs of relations with others (pregnant women). Also central to this ethical orientation is responsiveness in an interconnected network of needs, care and prevention of harm. This review concludes by stressing that many human relationships involve persons who are vulnerable, including pregnant women, dependent, ill and or frail, noting that the desirable moral response is that prescribed by care ethics, which thus has implications for the practice of medicine in Nigeria.

Lanre-Abass, Bolatito A

2008-01-01

141

Principled leadership in public health: integrating ethics into practice and management.  

PubMed

Public health officials frequently face ethical tensions and conflicting obligations when making decisions and managing health departments. Leadership requires an ongoing approach to ethics that focuses on two dimensions of practice: the professional relationships of officials developed over time with their communities and the ethical aspects of day-to-day public health activities. Education and competencies in ethics may be helpful in practice, by providing, at a minimum, frameworks and ethical principles to help structure analysis, discussion, and decision making in health departments and with community stakeholders. Such a "practical ethics" approach in public health practice begins with a focus on public health values and an agency mission statement and integrates ethics throughout the organization by, for example, setting performance measures based on them. Using a case in emergency preparedness, this article describes ways in which ethical frameworks and the Code of Ethics can be used as tools for education and to integrate ethics into agency activities and programs. PMID:18552647

Bernheim, Ruth Gaare; Melnick, Alan

142

Translational ethics? The theory–practice gap in medical ethics  

Microsoft Academic Search

Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be ‘made practical’. This paper considers the prospects of a corresponding movement of ‘translational ethics’. Some of the advantages

Alan Cribb

2010-01-01

143

Should dingoes die? Principles for engaging ecocentric ethics in wildlife tourism management  

Microsoft Academic Search

Ethics underlie all our decisions and actions. The aim of this paper is to, first, highlight the sorts of ethical positions that inform wildlife management and, second, to propose a different set of ecocentric ethical principles that not only provide for a more authentic visitor experience of nature, but also enhance the long-term survival of wildlife. An ecocentric approach involves

Georgette Leah Burns; Jim MacBeth; Susan Moore

2011-01-01

144

Autonomy in medical ethics after O'Neill  

PubMed Central

Following the influential Gifford and Reith lectures by Onora O'Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O'Neill in recommending a principled version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring "patient autonomy" when it is, in fact, abrogation of their duty as doctors.

Stirrat, G; Gill, R

2005-01-01

145

Ethical objections to sex selection for non-medical reasons  

Microsoft Academic Search

This paper examines the main ethical argument used to support the use of sex selection for non-medical reasons, namely that sex selection for non-medical reasons should be allowed on the grounds of reproductive autonomy. A critique of this argument is offered, concluding that sex selection for non-medical reasons should not be permitted.

Eric Blyth; Lucy Frith; Marilyn Crawshaw

2008-01-01

146

The Context of Ethical Problems in Medical Volunteer Work  

Microsoft Academic Search

Ethical problems are common in clinical medicine, so medical volunteers who practice clinical medicine in developing countries\\u000a should expect to encounter them just as they would in their practice in the developed world. However, as this article argues,\\u000a medical volunteers in developing countries should not expect to encounter the same ethical problems as those that dominate\\u000a Western biomedicine or to

Anji Wall

2011-01-01

147

Risk Assessment and Management for Medically Complex Potential Living Kidney Donors: A Few Deontological Criteria and Ethical Values  

PubMed Central

A sound evaluation of every bioethical problem should be predicated on a careful analysis of at least two basic elements: (i) reliable scientific information and (ii) the ethical principles and values at stake. A thorough evaluation of both elements also calls for a careful examination of statements by authoritative institutions. Unfortunately, in the case of medically complex living donors neither element gives clear-cut answers to the ethical problems raised. Likewise, institutionary documents frequently offer only general criteria, which are not very helpful when making practical choices. This paper first introduces a brief overview of scientific information, ethical values, and institutionary documents; the notions of “acceptable risk” and “minimal risk” are then briefly examined, with reference to the problem of medically complex living donors. The so-called precautionary principle and the value of solidarity are then discussed as offering a possible approach to the ethical problem of medically complex living donors.

Petrini, Carlo

2011-01-01

148

Chinese Confucian culture and the medical ethical tradition.  

PubMed Central

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.

Guo, Z

1995-01-01

149

Original Articles Ethical Dilemmas and the Moral Reasoning of Medical Students Ethical Dilemmas and the Moral Reasoning of Medical Students  

Microsoft Academic Search

Objectives: To analyze the responses of medical students to ethical dilemmas commonly encountered in the clinical setting. Subjects and Method: A questionnaire based cross sectional survey was conducted on final year medical stu- dents from three different medical colleges in Karachi, Pakistan. Results: One hundred and twenty two students participated. Fifty eight percent were willing to withdraw ventila- tory support

A. M. Jafarey; A. Farooqui

150

Cultural context in medical ethics: lessons from Japan.  

PubMed

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

Powell, Tia

2006-04-03

151

The literature of medical ethics: Bernard H?ring  

PubMed Central

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.

Soane, Brendan

1977-01-01

152

Ethics: An Essential Dimension of Clinical Obstetric Anesthesia  

Microsoft Academic Search

thics is an essential dimension of clinical obstetric anesthesia. In this article, we provide a frame- work for addressing ethical issues in obstetric anesthesia. The components of this framework include definitions of medical ethics and obstetric ethics, vir- tues and ethical principles, and the concept of the fetus as a patient (1). Medical Ethics and Obstetric Ethics

Frank A. Chervenak; Laurence B. McCullough; David J. Birnbach

2003-01-01

153

The Opinions of Preschool Teachers about Ethical Principles  

ERIC Educational Resources Information Center

Can we fulfill our responsibilities and obligations while we are working? Today, professional ethics is a necessity for each occupation. As teachers are directly responsible for children's growth, professional ethics and ethical decision making are important for them. Although many countries, particularly the United States, have prepared ethics

Ozturk, Safak

2010-01-01

154

New trends of short-term humanitarian medical volunteerism: professional and ethical considerations.  

PubMed

Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Increasingly, both volunteers and their respective institutions have faced important challenges in regard to medical ethics and professional codes that should not be overlooked. We explore these potential concerns and their risk factors in three categories: ethical responsibilities in patient care, professional responsibility to communities and populations, and institutional responsibilities towards trainees. We discuss factors increasing the risk of harm to patients and communities, including inadequate preparation, the use of advanced technology and the translation of Western medicine, issues with clinical epidemiology and test utility, difficulties with the principles of justice and clinical justice, the lack of population-based medicine, sociopolitical effects of foreign aid, volunteer stress management, and need for sufficient trainee supervision. We review existing resources and offer suggestions for future skill-based training, organisational responsibilities, and ethical preparation. PMID:23236086

Asgary, Ramin; Junck, Emily

2012-12-12

155

Medical Ethics and the Hopelessly Ill Child  

ERIC Educational Resources Information Center

|The author reviews some of his observations regarding the responsibility of the physician caring for the hopelessly ill child and presents the resolutions proposed in 1974 by the adhoc committee on Ethics and Survival. (SB)|

Waldman, A. Martin

1976-01-01

156

Metaphysics and medical ethics: a reply.  

PubMed

The total longitudinal form view of human beings is a metaphysical view which aims to locate our moral judgements about human embryos in a broader set of attitudes and characterisations. On this basis it has explanatory power and a real function in that it grounds our ethical discussion of embryos in other discourses. Contra Leavitt, this grounding suggests a broader criterion of relevance for metaphysical discussion than asking 'what comes out of' such a discussion for a particular ethical dilemma. PMID:8035442

Gillett, G

1994-03-01

157

Stem cell politics, ethics and medical progress.  

PubMed

Tremendous controversy has surrounded efforts to undertake research on totipotent human stem cells. To date public policy in the United States has attempted to skirt the ethical and social questions raised by this research. Annas et al. argue that research using human embryos as a source of totipotent stem cells can secure broad public support if there is an open and public discussion about the ethical justification for undertaking such research and the assurance of adequate federal regulation and oversight. PMID:10581063

Annas, G J; Caplan, A; Elias, S

1999-12-01

158

Ethics education in medical schools: the role of jurists.  

PubMed

Ethical thinking has always existed in the area of medicine. The oldest law case has known human experiment difficulties, but this comes from the doctor. The power of the practitioner relies on the lack of medical knowledge of the patient and often in practice, on the lack of information for the patient. The doctor has ethical difficulties when he considers the patient and the solution, in fact is dependent on his conscience. With the various medical discoveries, the doctor can create life (assisted procreation), manipulate life (gene therapy) and suppress life (abortion, suppression of frozen embroyos). These discoveries have increased the necessity for ethical reflection. Ethics committees have been created at local level (as part of special establishments or departments) rather than at national and international levels. The scope of the stakes (the development of the human race) give to this ethical reflection a multidisciplinary approach. There is a general tendency for the influence of law in these fields. Therefore, the jurist has a more and more important place on these ethics committees. Actually, the interaction from ethics to law is frequent. Also during legal proceedings, a jurist has and will have more and more need of a medical assessor. So, cooperation is necessary between doctors and jurists. The teaching of ethics in medical schools by the jurist can be important because it will recall the humanist mission of the doctor. The jurist must be able to increase the medical professions' awareness of essential notions such as respect for the fundamental rights of the human being. PMID:11143876

Feuillet-Le Mintier, B

2000-01-01

159

Simulation-Based Medical Education: An Ethical Imperative  

Microsoft Academic Search

Medical training must at some point use live patients to hone the skills of health professionals. But there is also an obligation to provide optimal treatment and to ensure patients' safety and well-being. Balancing these two needs represents a fundamental ethical tension in medical education. Simulation-based learning can help mitigate this tension by developing health professionals' knowledge, skills, and attitudes

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

2003-01-01

160

Australian medical students' perceptions of professionalism and ethics in medical television programs  

PubMed Central

Background Medical television programs offer students fictional representations of their chosen career. This study aimed to discover undergraduate medical students' viewing of medical television programs and students' perceptions of professionalism, ethics, realism and role models in the programs. The purpose was to consider implications for teaching strategies. Methods A medical television survey was administered to 386 undergraduate medical students across Years 1 to 4 at a university in New South Wales, Australia. The survey collected data on demographics, year of course, viewing of medical television programs, perception of programs' realism, depiction of ethics, professionalism and role models. Results The shows watched by most students were House, Scrubs, and Grey's Anatomy, and students nominated watching 30 different medical programs in total. There was no statistical association between year of enrolment and perceptions of accuracy. The majority of students reported that friends or family members had asked them for their opinion on an ethical or medical issue presented on a program, and that they discussed ethical and medical matters with their friends. Students had high recall of ethical topics portrayed on the shows, and most believed that medical programs generally portrayed ideals of professionalism well. Conclusions Medical programs offer considerable currency and relevance with students and may be useful in teaching strategies that engage students in ethical lessons about practising medicine.

2011-01-01

161

Awareness of medical ethics among undergraduates in a West Bengal medical college.  

PubMed

This descriptive, cross-sectional study was conducted to assess the knowledge of and attitudes towards medical ethics among undergraduate medical students. It also looked at whether there was any improvement with additional years of medical education. 340 medical students of a medical college in West Bengal were given a semi-structured questionnaire that included questions regarding their awareness of ethics, their attitudes towards various issues in clinical ethics, and their knowledge of the code of medical ethics of the West Bengal Medical Council. The responses of 322 students were analysed by simple descriptive statistics. The students generally agreed that awareness of ethics was important. Lectures (54.7%) and books (47.8%) were their predominant sources of knowledge. Only 10.9 % were aware of the existence of an institutional ethics committee and 42.8% did not know its exact role. Their answers showed that the majority of students expressed mixed responses--both desirable and undesirable--in relation to questions exploring different aspects of basic ethical reasoning in their professional life. The most desirable response for each statement was decided by experts of forensic medicine and also from a literature study. Only half the respondents (50.9%) had a good score (61-70 out of a total possible 90) and 37.2% had a fair score (51-60). There was no increase in scores corresponding with additional years of medical education. PMID:22591867

Chatterjee, Biswajit; Sarkar, Jhuma

162

The teaching of medical ethics: University College, Cork, Ireland.  

PubMed Central

Dolores Dooley Clarke describes how the course in medical ethics at University College, Cork is structured, how it has changed and how it is likely to change as time goes on. Originally, the students seemed to view it as an intrusion 'to be tolerated' in their programme of 'strictly medical' studies. However, having moved on from that and away from the lecturer always being a Roman Catholic priest as well as a member of the Philosophy Department, the students now appear to view it as producing a stimulus for a new interest in the area of ethics for physicians. This seems to have come about through the more extensive participation of students in researching and presenting issues of medical ethics.

Clarke, D D

1978-01-01

163

[Conscience, principled refusal and ethics of refusal to provide treatment to a patient's request].  

PubMed

There are situations in which refusal to provide treatment according to a patient's request may be justified by ethical rules and principles of medical ethics. This article explores such situations, analyzing the various factors which a physician may consider when refusal to provide treatment is at stake. The article focuses on three major states of affairs under which the question of whether a physician has liberty to refuse to treat may occur: refusals deriving from conflicts between the physician's personal values and ones reflected in the proposed treatment; refusals stemming from general considerations to be classified as policy reasons; and refusals following a clinical assessment as to the proposed treatment, expected chances of recovery and expected benefit to the patient. The ethical analysis of the article leads to the conclusion that a physician may (although he/she does not have a right to) refuse to provide medical treatment following a patient's request when the physician's refusal originates in conscientious resistance. However, the physician may not refuse to treat when refusal is based on policy considerations or concerns third parties not immediately involved in the physician-patient relationship. In addition, a physician may refuse to provide treatment following a medical assessment when and if the proposed treatment is not urgently required, if the provision of treatment may create risks to the patient's health, if its conferral may inflict pain or suffering exceeding its expected benefits to the patient, or the proposed treatment is futile and its chances to combat the disease are significantly minimal. PMID:18770960

Sperling, Daniel

2008-05-01

164

Medical ethics in peace and in the armed conflict.  

PubMed

Global medical ethics on the basis of the General Declaration of Human Rights by the United Nations is a key subject for the 21st century. World Health Organization's new definition of health includes "spiritual health," a term that has to be defined in international consensus despite different anthropologies, cultures, and religions. Old issues in medical ethics such as assisted suicide are still waiting for global consensus among the "pro-life" and "pro-choice" parties. So far The Netherlands and Belgium are the only countries where euthanasia has been legalized, whereas the U.S. Supreme Court has denied a right of medically assisted suicide. The respect of nature is also the basis for guidelines in new issues in medical ethics such as gene therapy and human cloning, which are controversially discussed. Military medical ethics should provide regulations for morally correct decisions in armed conflicts including the war against international terrorism and in peacekeeping missions. Triage of the wounded, distribution of medical aid, and critical incident stress debriefing for soldiers and their relatives are key issues. PMID:12186301

Schapowal, Andreas G; Baer, Hans-Ulrich

2002-08-01

165

Sin and suffering in a Catholic understanding of medical ethics.  

PubMed

Drawing chiefly on recent sources, in Part One I sketch an untraditional way of articulating what I claim to be central elements of traditional Catholic morality, treating it as based in virtues, focused on the recipients ("patients") of our attention and concern, and centered in certain person-to-person role-relationships. I show the limited and derivative places of "natural law," and therefore of sin, within that framework. I also sketch out some possible implications for medical ethics of this approach to moral theory, and briefly contrast these with the influential alternative offered by the "principlism" of Beauchamp and Childress. In Part Two, I turn to a Catholic understanding of the nature and meaning of human suffering, drawing especially on writings and addresses of the late Pope John Paul II. He reminds us that physical and mental suffering can provide an opportunity to share in Christ's salvific sacrifice, better to see the nature of our earthly vocation, and to reflect on the dependence that inheres in human existence. At various places, and especially in my conclusion, I suggest a few ways in which this can inform bioethical reflection on morally appropriate responses to those afflicted by physical or mental pain, disability, mental impairment, disease, illness, and poor health prospects. My general point is that mercy must be informed by appreciation of the person's dignity and status. Throughout, my approach is philosophical rather than theological. PMID:16864134

Garcia, J L A

2006-08-01

166

Informed consent and ethical issues in military medical research.  

PubMed

Informed consent in military research shares many of the same fundamental principles and regulations that govern civilian biomedical research. In fact, much of modern research ethics is grounded in events that occurred in the context of war or government-sponsored research. Despite these similarities and common origins, research in the military has additional requirements designed to preserve service members' informed consent rights. The special nature of the superior-subordinate relationship in the military necessitates careful protections to avoid perceptions of coercion or undue influence on a military subject. Additionally, current legal and regulatory requirements for advanced informed consent significantly restrict the flexibility of the military to conduct research using waiver of consent. This has implications on the ability of the nation to develop effective medical treatments for the global war on terrorism. Nevertheless, work is under way to realign defense research policy with the norms of civilian biomedical practice. Future directions include the adoption of waivers for military emergency research, and the cautious introduction of human subject studies on the battlefield. This paper discusses historical background, regulatory differences, and concerns and challenges of some of these regulatory differences for research personnel that apply to informed consent and waiver of said informed consent for emergency research conducted by the U.S. military. PMID:16264083

McManus, John; Mehta, Sumeru G; McClinton, Annette R; De Lorenzo, Robert A; Baskin, Toney W

2005-11-01

167

Annual report of Council, 1986-1987: medical ethics.  

PubMed

Recent activities of the Council of the British Medical Association (BMA) related to ethical and public policy issues are described. Concerning contraception for minors, the BMA continues to recommend that only in "exceptional" cases should contraceptive advice be given without parental consent. Among the other issues considered by the BMA were the "intimate searches" section of the Police and Criminal Evidence Act; the protection of personal health information held by the National Health Service; the establishment of a national ethical research committee; the General Medical Council's revised guidance on advertising; the government's report on "Primary Health Care"; and investigations of doctors' involvement with torture or collaboration with oppressive regimes. PMID:11652496

1987-03-28

168

The development of computer ethics: contributions from business ethics and medical ethics.  

PubMed

In this essay, we demonstrate that the field of computer ethics shares many core similarities with two other areas of applied ethics. Academicians writing and teaching in the area of computer ethics, along with practitioners, must address ethical issues that are qualitatively similar in nature to those raised in medicine and business. In addition, as academic disciplines, these three fields also share some similar concerns. For example, all face the difficult challenge of maintaining a credible dialogue with diverse constituents such as academicians of various disciplines, professionals, policymakers, and the general public. Given these similarities, the fields of bioethics and business ethics can serve as useful models for the development of computer ethics. PMID:11273451

Wong, K; Steinke, G

2000-04-01

169

Clinical research ethics in Irish healthcare: diversity, dynamism and medicalization.  

PubMed

Gaining ethical clearance to conduct a study is an important aspect of all research involving humans but can be time-consuming and daunting for novice researchers. This article stems from a larger ethnographic study that examined research capacity building in Irish nursing and midwifery. Data were collected over a 28-month time frame from a purposive sample of 16 nurse or midwife research fellows who were funded to undertake full-time PhDs. Gaining ethical clearance for their studies was reported as an early 'rite of passage' in the category of 'labouring the doctorate'. This article penetrates the complexities in Irish clinical research ethics by describing the practices these nurse and midwife researchers encountered and the experiences they had. The key issue of representation that occurred in the context of 'medicalized' research ethics is further explored including its meaning for nursing or midwifery research. PMID:22691601

Condell, Sarah L; Begley, Cecily

2012-06-12

170

Ethical Principles in the Counseling of Gay and Lesbian Adolescents: Issues of Autonomy, Competence, and Confidentiality  

Microsoft Academic Search

Ethical dilemmas in counseling gay and lesbian adolescents are analyzed according to underlying ethical principles. Developmental issues and their relevance to therapy are emphasized. Conflicts among client autonomy, claims of paternalism, and limits of confidentiality are examined. Competence to enter therapy for issues of sexual identity is assessed. The author concludes that adolescents are generally competent to explore issues of

Michael R. Sobocinski

1990-01-01

171

Principles, virtues and care: ethical dilemmas in research with male sex offenders  

Microsoft Academic Search

This paper considers ethical dilemmas associated with research with male sex offenders. It examines two particular areas in detail: dealing with the disclosure of previously undisclosed offences and managing the distress of research participants during interview. Within these areas there is discussion of ethical approaches to research. Principle-based approaches offer abstract guidelines that help to resolve certain issues, but at

Malcolm Cowburn

2010-01-01

172

Ethics Education in U.S. Medical Schools: A Study of Syllabi.  

ERIC Educational Resources Information Center

|Surveyed medical schools to determine the scope and content of required, formal ethics components in their curriculums. Found that ethics education is far from homogeneous among medical schools in both content and extensiveness. (EV)|

DuBois, James M.; Burkemper, Jill

2002-01-01

173

The internet doctor and medical ethics. Ethical implications of the introduction of the Internet into medical encounters.  

PubMed

In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy. PMID:12168987

Collste, Göran

2002-01-01

174

Ethics and the comprehensive application of epistemology in medical practice.  

PubMed

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

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

2005-12-01

175

Gene Therapy Progress and Prospects: Bringing gene therapy into medical practice: the evolution of international ethics and the regulatory environment  

Microsoft Academic Search

The concept and application of ethical principles in the context of medical research is changing rapidly. This is especially true for fast moving fields such as gene therapy, a relatively new but rapidly maturing field offering opportunities to influence health at a fundamental level, which may become a cornerstone of medicine. By 2004, over 700 gene therapy clinical protocols had

J Spink; D Geddes

2004-01-01

176

Ethical Principles for the Management of Infants with Disorders of Sex Development  

Microsoft Academic Search

The Fifth World Congress on Family Law and Children’s Rights (Halifax, August 2009) adopted a resolution endorsing a new set of ethical guidelines for the management of infants and children with disorders of sex development (DSD) [www.lawrights.asn.au\\/index.php?option=com_content&view=article&id=76&Itemid=109]. The ethical principles developed by our group were the basis for the Halifax Resolution. In this paper, we outline these principles and explain

Lynn H. Gillam; Jacqueline K. Hewitt; Garry L. Warne

2010-01-01

177

A randomized trial of ethics education for medical house officers  

Microsoft Academic Search

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

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

1993-01-01

178

Undergraduate International Medical Electives: Some Ethical and Pedagogical Considerations  

ERIC Educational Resources Information Center

|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…

Hanson, Lori; Harms, Sheila; Plamondon, Katrina

2011-01-01

179

Teaching medical ethics to experienced staff: participants, teachers and method  

Microsoft Academic Search

Almost all articles on education in medical ethics present proposals for or describe experiences of teaching students in different health professions. Since experienced staff also need such education, the purpose of this paper is to exemplify and discuss educational approaches that may be used after graduation. As an example we describe the experiences with a five-day European residential course on

Tore Nilstun; Marina Cuttini; Rodolfo Saracci

2001-01-01

180

Ethics and the ethnography of medical research in Africa  

Microsoft Academic Search

The ethics of medical research have grown as an area of expertise and debate in recent years, with two broad approaches emerging in relation to transnational research: (1) the refinement of guidelines and strengthening of review, processes primarily to protect the right of individual research participants and strengthen interpersonal relations at the micro-level; and (2) considering more centrally, as crucial

Sassy Molyneux; P. Wenzel Geissler

2008-01-01

181

Undergraduate International Medical Electives: Some Ethical and Pedagogical Considerations  

ERIC Educational Resources Information Center

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…

Hanson, Lori; Harms, Sheila; Plamondon, Katrina

2011-01-01

182

Patenting medical devices: the economic implications of ethically motivated reform.  

PubMed

This article explores whether the current patent system strikes the optimal balance between providing incentives to inventors to bring new medical devices to the marketplace and promoting public health by ensuring that these medical devices are widely available at a reasonable price. After providing an overview of the relationship of patent law to medical devices, the author explains how ethical and economic considerations suggest the need for an alternative patent system for medical devices and notes the difficulties with this proposal. The author concludes that a combination of alternatives to the current system most equitably account for the interests and needs of both healthcare device consumers and producers. PMID:18365652

Nugent, Kristen

2008-01-01

183

Drones--ethical considerations and medical implications.  

PubMed

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

Pepper, Tom

2012-01-01

184

Using Basic Ethical Principles to Evaluate Safety Efforts in Transfusion Medicine  

PubMed Central

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.

Brooks, Jay P.

2012-01-01

185

Putting Principles into Practice: Developing Ethical Leadership in Local Government  

Microsoft Academic Search

This article looks at the role of leadership development in the ethical leadership of English local government. Since the development of the ethical framework with the Local Government Act 2000 leadership has been seen to be increasingly important, although comparatively little consideration has been given to what this actually means in practice. This article seeks to investigate the situation in

Paul Iles; Michael Macaulay

2007-01-01

186

Ethics and policy of medical brain drain: a review.  

PubMed

Health-worker migration, commonly called "medical brain drain", refers to the mass migration of trained and skilled health professionals (doctors, nurses, midwives) from low-income to high-income countries. This is currently leaving a significant number of poor countries, particularly in sub-Saharan Africa, with critical staff shortages in the healthcare sector. A broad consensus exists that, where medical brain drain exacerbates such shortages, it is unethical, and this review presents the main arguments underpinning this view. Notwithstanding the general agreement, which policies are justifiable on ethical grounds to tackle brain drain and how best to go about implementing them remains controversial. The review offers a discussion of the specific ethical issues that have to be taken into account when deciding which policy measures to prioritise and suggests a strategy of policy implementation to address medical brain drain as a matter of urgency. PMID:24163012

Kollar, E; Buyx, A

2013-10-25

187

Recurring themes arising during medical research ethics committee review.  

PubMed

A standard application form for the ethical review of health-related research studies has recently been adopted by many Irish medical research ethics committees. In order to assess the impact of the new form, we reviewed all comments made by the Beaumont Hospital Ethics Committee during two six-month periods, immediately prior to adoption of the new form (2010), and soon afterwards (2011). Neither volume nor comment type differed significantly between the two observation periods. Participant documentation (information leaflets and consent forms) accounted for the largest proportion of comments (2010; 44%, 2011; 37%). Other common areas prompting queries were study administration (7%), design (12%) and procedures (13%), participant selection and recruitmen (8%), and lastly data protection (9%). Because of these findings, the standard operating procedures of the committee have been revised--use of provided template participant documentation is strongly encouraged, and a "Recurring Review Themes" checklist is highlighted to all applicants. PMID:23909158

Kelleher, E; Stanton, A; Vale, G; Smith, D

2013-06-01

188

Professional medical organizations and commercial conflicts of interest: ethical issues.  

PubMed

The American Academy of Family Physicians (AAFP) has recently been criticized for accepting a large corporate donation from Coca-Cola to fund patient education on obesity prevention. Conflicts of interest, whether individual or organizational, occur when one enters into arrangements that reasonably tempt one to put aside one's primary obligations in favor of secondary interests, such as financial self-interest. Accepting funds from commercial sources that seek to influence physician organizational behavior in a direction that could run counter to the public health represents one of those circumstances and so constitutes a conflict of interest. Most of the defenses offered by AAFP are rationalizations rather than ethical counterarguments. Medical organizations, as the public face of medicine and as formulator of codes of ethics for their physician members, have special obligations to adhere to high ethical standards. PMID:20644191

Brody, Howard

189

Ethical Principles and Guidelines for the Development of Cognitive Systems.  

National Technical Information Service (NTIS)

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 ...

W. L. Shaneyfelt

2006-01-01

190

Violation of ethical principles in clinical research. Influences and possible solutions for Latin America  

PubMed Central

Background Even though we are now well into the 21st century and notwithstanding all the abuse to individuals involved in clinical studies that has been documented throughout History, fundamental ethical principles continue to be violated in one way or another. Discussion Here are some of the main factors that contribute to the abuse of subjects participating in clinical trials: paternalism, improper use of informed consent, lack of strict ethical supervision, pressure exerted by health institutions to increase the production of scientific material, and the absence of legislation regarding ethics in terms of health care and research. Are researchers ready to respect fundamental ethical principles in light of the ample window of information provided by individual genomes, while defending the rights of the subjects participating in clinical studies as a major priority? Summary As one of the possible solutions to this problem, education regarding fundamental ethical principles is suggested for participants in research studies as an initial method of cognitive training in ethics, together with the promotion of ethical behavior in order to encourage the adoption of reasonable policies in the field of values, attitudes and behavior.

2012-01-01

191

Medical and ethical considerations in uterus transplantation.  

PubMed

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

Benagiano, Giuseppe; Landeweerd, Laurens; Brosens, Ivo

2013-07-31

192

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

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…

Fahy, Pat; Spencer, Bob

2004-01-01

193

Simulation-based medical education: an ethical imperative.  

PubMed

Medical training must at some point use live patients to hone the skills of health professionals. But there is also an obligation to provide optimal treatment and to ensure patients' safety and well-being. Balancing these two needs represents a fundamental ethical tension in medical education. Simulation-based learning can help mitigate this tension by developing health professionals' knowledge, skills, and attitudes while protecting patients from unnecessary risk. Simulation-based training has been institutionalized in other high-hazard professions, such as aviation, nuclear power, and the military, to maximize training safety and minimize risk. Health care has lagged behind in simulation applications for a number of reasons, including cost, lack of rigorous proof of effect, and resistance to change. Recently, the international patient safety movement and the U.S. federal policy agenda have created a receptive atmosphere for expanding the use of simulators in medical training, stressing the ethical imperative to "first do no harm" in the face of validated, large epidemiological studies describing unacceptable preventable injuries to patients as a result of medical management. Four themes provide a framework for an ethical analysis of simulation-based medical education: best standards of care and training, error management and patient safety, patient autonomy, and social justice and resource allocation. These themes are examined from the perspectives of patients, learners, educators, and society. The use of simulation wherever feasible conveys a critical educational and ethical message to all: patients are to be protected whenever possible and they are not commodities to be used as conveniences of training. PMID:12915366

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

2003-08-01

194

La ética en la práctica. Cuando algo se hace mal: del error médico a la mala praxis Ethics in Practice. When something is done wrong: from the medical error to the malapraxis  

Microsoft Academic Search

Objective: To analyse two of the most significant ethical issues related to medical errors: informing patients and relatives; and the moral duty to prevent and try to minimise this situation. Design: The recommended ethical and medical principles are consistent with those of medicine in general and are underpinned by the specific guidelines published by professional organisations, such as the American

León Sanz P

195

Ethical issues in the daily medical care of children  

Microsoft Academic Search

The main ethical imperative of all paediatric actions is the demand to do everything “in the best interests of children”.\\u000a Relevant guidelines can be derived from the UN Declaration on the Rights of Children, whereupon every child has the fundamental\\u000a right to life and dignity, and is entitled to optimal medical care. Paediatric care in general includes the responsibility\\u000a to

R. Kurz; D. Gill; S. Mjones

2006-01-01

196

Medical and ethical dilemma in brain death.  

PubMed

For centuries, death has been defined, medically speaking, as the irreversible cessation of breathing and of nervous and cardiac activity. What radically changed this definition was the introduction of the concept "brain death" in 1968, by the "Ad Hoc Committee of the Harvard Medical School". According to it, the irreversible coma was associated with brain death and considered to be a criterion for the diagnosis of the deceased individual. The evergrowing need for transplant organs (provided this respects the dead honor rule, stipulating that organs can't be harvested unless someone is deceased) lead to making arbitrary decisions regarding the establishment of the exact time of death during the process of "losing life". What actually triggers the controversy related to the concept of brain death is the dilemma of associating this concept with that of biologic death or death of the person, the difference between the two being made by whether the mental characteristics are accepted or not in defining and individualizing the death of the human being. Given these circumstances, a dilemma appears--that of defining the death of the individual: we define death, as it has been for centuries, as the moment when the cardio-respiratory function no longer exists, which leads to the loss of tens of thousands of lives that might have been saved through transplant. Yet, this may lead to manipulating the border between life and death, with the risk of trespassing each individual's right to life. PMID:23272519

Streba, Irina; Damian, Simona; Ioan, Beatrice

197

[Assisted suicide - medical, legal, and ethical aspects].  

PubMed

Unlike in most European countries, assisted suicide is not illegal in Switzerland. The number of assisted suicides procured by right-to-die organisations such as Exit or Dignitas has sharply increased in the last twenty years. Central part of the doctor's involvement is the prescription of a lethal dose of sodium pentobarbital. In doing so, the doctor has to apply to the rules of medical due care. A proper examination of the patient is required, who must be informed about his diagnosis, about the expected prognosis, and about different treatment options. Verification of the patient's decisional capacity is crucial. In general, a staff member of the organisation but not the doctor is present during suicide. Following death, the assisted suicide has to be reported to the police as an extraordinary death case. PMID:22294304

Bosshard, G

2012-02-01

198

Ethical Principles in Practice: Evidence from Participatory Action Research  

ERIC Educational Resources Information Center

|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…

Smith, Liz

2008-01-01

199

Assessing the clinical ethical competence of undergraduate medical students.  

PubMed Central

At the University of Newcastle, health law and ethics is taught and assessed in each year of the five-year curriculum. However, the critical question for assessment remains: 'Does teaching ethics have a measurable effect on the clinical activity of medical students who have had such courses?' Those responsible for teaching confront this question each year they sit down to construct their assessment tools. Should they assess what the student knows? Should they assess the student's moral reasoning, that is, what decisions the student makes, and, how these decisions are justified, or should they assess what the student actually does when dealing with patients in the clinical setting, and how he or she does it? From 1982 to 1991, assessment at Newcastle was primarily aimed at determining the quality of the students' ethics knowledge base. This paper describes the strengths and limitations of a purely knowledge-based method of evaluation and why in 1992, we are now attempting to redefine and assess, what we call 'clinical ethical competence' in terms of how students actually apply this knowledge base in a controlled clinical context.

Mitchell, K R; Myser, C; Kerridge, I H

1993-01-01

200

History of evolution of the concept of medical ethics.  

PubMed

"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

Majumdar, Sisir K

201

Medical navigation in Israel: description, advantages and ethical considerations.  

PubMed

Throughout history religious figures have been intimately involved in caring for the sick. Not only have they prayed for the welfare of the sick and arranged for their care but in many instances provided medical care as well. With the advent of scientific medicine, the responsibility for medical care was transferred to trained physicians. A new phenomenon has recently emerged in Israel that has threatened this 'division of labor' between physicians and rabbis, namely, the establishment of medical navigation organizations. Medical navigation can improve access to highly specialized care and help build trust between doctors and patients. However, this system is accompanied by numerous ethical and professional difficulties. For example, it is not clear how referrals are made and to what extent the system should be regulated. The phenomenon needs to be further studied to determine its prevalence in Israeli society as well as its impact on the practice of medicine from the perspective of both physicians and patients. PMID:23516765

Jotkowitz, Alan

2013-02-01

202

The precautionary principle and medical decision making.  

PubMed

The precautionary principle is a useful strategy for decision-making when physicians and patients lack evidence relating to the potential outcomes associated with various choices. According to a version of the principle defended here, one should take reasonable measures to avoid threats that are serious and plausible. The reasonableness of a response to a threat depends on several factors, including benefit vs. harm, realism, proportionality, and consistency. Since a concept of reasonableness plays an essential role in applying the precautionary principle, this principle gives physicians and patients a decision-making strategy that encourages the careful weighing and balancing of different values that one finds in humanistic approaches to clinical reasoning. Properly understood, the principle presents a worthwhile alternative to approaches to clinical reasoning that apply expected utility theory to decision problems. PMID:15512973

Resnik, David B

2004-06-01

203

Principles and Methods of Medical Geographic Mapping.  

National Technical Information Service (NTIS)

Contents: Key problems in mapping in the field of medical geography; Experience in compiling small-scale specialized zoogeographic maps with medical geographic content; Experience in mapping the population of black-legged ticks carriers of natural focal i...

1969-01-01

204

Unwanted pregnancy--medical and ethical dimensions.  

PubMed

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

Ravindran, J

2003-03-01

205

How Christian ethics became medical ethics: the case of Paul Ramsey.  

PubMed

Over the last century Christian ethics has moved from an attempt to Christianize the social order to a quandary over whether being Christian unduly biases how medical ethics is done. This movement can be viewed as the internal development of protestant liberalism to its logical conclusion, and Paul Ramsey can be taken as one of the last great representatives of that tradition. By reducing the Christian message to the 'ethical upshot' of neighbour love, Ramsey did not have the resources to show how Christian practice might make a difference for understanding or forming the practice of medicine. Instead, medicine became the practice that exemplified the moral commitments of Christian civilization, and the goal of the ethicist was to identify the values that were constitutive of medicine. Ramsey thus prepared the way for the Christian ethicist to become a medical ethicist with a difference, and the difference simply involved vague theological presumptions that do no serious intellectual work other than explaining, perhaps, the motivations of the ethicist. PMID:11652925

Hauerwas, Stanley

1995-03-01

206

Consent: ethical considerations  

Microsoft Academic Search

Respect for patient's autonomy is now regarded as the central ethical principle in medical practice. A successful doctor-patient relationship depends on trust, and to establish that trust doctors need to respect the patient's autonomy. All medical codes of ethics now hold that doctors have a duty to obtain the consent of patients before undertaking procedures. To give valid consent the

Nick Pace; Rob Hendry

2006-01-01

207

Principles and practice of medical audit (medical care evaluation).  

PubMed

1. Medical audit is a philosophy in the field of medical science which has reached to an advanced stage of practice in Western World, but yet to reach and percolate into Indian medical community. 2. Of late, community is getting increasingly aware of its health rights, gradually community participation in health matters including quantum and quality of case, has started increasing. Thus community leaders have started demanding for quality of medical care and accountability of those, responsible for delivery of medical care at various levels. 3. Medical audit or Evaluation of medical care is an answer to ensure the quality of care. But there are misgivings and distrust about medical audit due to its terminology. 4. There is need to education the medical, nursing and paramedical staff regarding medical audit and its sole purpose of self education and improvement of patient care activity. The present paper spells out fundamentals of medical audit, its scope and limitations. PMID:10130922

Srivastava, M; Sharma, D K

1992-01-01

208

From an Exercise in Professional Etiquette to Society's Wish List? Council on Ethical and Judicial Affairs, American Medical Association. Code of Medical Ethics: Current Opinions with Annotations. Chicago: American Medical Association, 2002. 228 pp. $50.00, softcover only  

Microsoft Academic Search

The Council on Ethical and Judicial Affairs of the American Medical Association (AMA) recently published the 2002–2003 edition of The Code of Medical Ethics. This annotated version is published on a biennial basis and compiles the ethical position of the AMA on more than 175 speciªc issues, ranging from social-policy issues such as capital punishment, HIV testing, and multiplex genetic

Tom Meulenbergs

2004-01-01

209

The teaching of medical ethics in the Federal Republic of Germany  

Microsoft Academic Search

Eduard Seidler sets his discussion of the teaching of medical ethics in the Federal Republic of Germany against an historical background. Immediately after the Second World War the freshness of the memory of the 'Nuremberg Medical Trials' influenced the way in which moral dilemmas were treated in Germany. At the present time no systematic instruction in medical ethics is provided

E Seidler

1979-01-01

210

Quality Time: Temporal and Other Aspects of Ethical Principles Based on a “Life Worth Living”  

Microsoft Academic Search

The evaluation of whether an animal has a life worth living (LWL) has been suggested as a useful concept for farm animal policymaking.\\u000a But there are a number of different ways in which the concept could be applied. This paper attempts to identify and evaluate\\u000a candidate ethical principles based on the concept. It suggests that an appropriate principle by which

James Yeates

211

Ethical principles as a guide in implementing policies for the management of food allergies in schools.  

PubMed

Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools. PMID:20348215

Behrmann, Jason

2010-03-26

212

A Comparison of General Medical and Clinical Ethics Consultations: What Can We Learn From Each Other?  

PubMed Central

Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important to help the medical community appreciate ethics consultation as a vital service in today's health care setting. Therefore, this Special Article presents a comparison of medical and clinical ethics consultations in terms of fundamental goals of consultation, roles of consultants, and methodologic approaches to consultation, concluding with reflections on important lessons about the physician-patient relationship and medical education that may benefit practicing internists. Our aim is to examine ethics consultation as a clinical service integral to the medical care of patients. Studies for this analysis were obtained through the PubMed database using the keywords ethics consultation, medical consultation, ethics consults, medical consults, ethics consultants, and medical consultants. All English-language articles published from 1970 through August 2011 that pertained to the structure and process of medical and ethics consultation were reviewed.

Geppert, Cynthia M.A.; Shelton, Wayne N.

2012-01-01

213

Medical ethics in an era of bioethics: resetting the medical profession's compass.  

PubMed

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of Bioethics International Congress (June, 2010). PMID:22270711

Pellegrino, Edmund D

2012-02-01

214

The Failure of Clinical Psychology Graduate Students to Apply Understood Ethical Principles  

Microsoft Academic Search

In a survey of 170 graduate students from 25 American Psychological Association- (APA-) approved clinical training programs, we asked them to state what they should do in a hypothetical situation in which a peer\\/friend is violating the Ethical Principles (APA, 1977, 1981) and then what they would do. Approximately half of these students would do less than they believe they

John L. Bernard; Carmen S. Jara

1986-01-01

215

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

Microsoft Academic Search

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 professional associations’ principles for research practice, the

Amanda L. Nolen; Jim Vander Putten

2007-01-01

216

Principle?oriented leadership: A case study of ethics in business  

Microsoft Academic Search

Four leadership styles are discussed: authoritarian, paternalistic, all?knowing, and manipulative. The drawbacks of each style are shown: they are hierarchical, with centralized structure and process, poorly adapted to contemporary society and the environment of business. In their place Principle?Oriented Leadership is suggested, at the same time effective and ethical, hallmarked by a search for values associated with unity, service, consultation,

Faramarz Ettehadieh

1998-01-01

217

Law and medical ethics in organ transplantation surgery  

PubMed Central

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?

Woodcock, Tom; Wheeler, Robert

2010-01-01

218

Medical ethics curriculum for surgical residents: Results of a pilot project  

Microsoft Academic Search

Introduction: This study sought to develop and evaluate a medical ethics curriculum designed specifically for surgical residents. Methods: The learning needs of surgical residents relevant to ethics were determined by using a structured literature review and synthesis strategy. We identified 5 primary areas of importance for ethics education for surgical residents: withdrawing and withholding treatment, advance directives, do-not-resuscitate orders, informed

Peter Angelos; Debra A. DaRosa; Anna M. Derossis; Benjamin Kim

1999-01-01

219

Doctors' stories, patients' stories: a narrative approach to teaching medical ethics.  

PubMed Central

Many senior doctors have had little in the way of formal ethics training, but express considerable interest in extending their education in this area. This paper is the report of an initiative in continuing medical education in which doctors were introduced to narrative ethics. We review the theoretical basis of narrative ethics, and the structure of and response to the two-day workshop.

Nicholas, B; Gillett, G

1997-01-01

220

Juridical and ethical peculiarities in doping policy  

Microsoft Academic Search

Criticisms of the ethical justification of antidoping legislation are not uncommon in the literatures of medical ethics, sports ethics and sports medicine. Critics of antidoping point to inconsistencies of principle in the application of legislation and the unjustifiability of ethical postures enshrined in the World Anti-Doping Code, a new version of which came into effect in January 2009. This article

Mike J McNamee; Lauri Tarasti

2010-01-01

221

Resolving Ethical Dilemmas: Exploring the Role of Moral Principles.  

National Technical Information Service (NTIS)

We sought to answer two questions via this exploratory study. First, we investigated whether or not individual differences in moral principle selection/preference existed in response to six moral dilemmas. Second, we sought to find out whether they were r...

A. Blais M. Thompsom

2008-01-01

222

The ethics of conducting graduate medical education research on residents.  

PubMed

The field of graduate medical education (GME) research is attracting increased attention and broader participation. The authors review the special ethical and methodological considerations pertaining to medical education research. Because residents are at once a convenient and captive study population, a risk of coercion exists, making the provision of consent important. The role of the institutional review board (IRB) is often difficult to discern because GME activities can have multiple simultaneous purposes, educational activities may go forward with or without a research component, and the subjects of educational research studies are not patients. The authors provide a road map for researchers with regard to research oversight by the IRB and also address issues related to research quality. The matters of whether educational research studies should have educational value for the study subject and whether to use individual information obtained when residents participate as research subjects are explored. PMID:23425981

Keune, Jason D; Brunsvold, Melissa E; Hohmann, Elizabeth; Korndorffer, James R; Weinstein, Debra F; Smink, Douglas S

2013-04-01

223

Medical ethics and the interrogation of Guantanamo 063.  

PubMed

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

Miles, Steven H

2007-04-01

224

The medical-legal quandary of healthcare in capital punishment: an ethical dilemma for the anesthesia provider.  

PubMed

The case of Brase v Rees was presented before the US Supreme Court to consider the constitutionality of death by lethal injection as practiced in the state of Kentucky. The 3-drug combination of sodium thiopental, pancuronium bromide, and potassium chloride is a key aspect in question. Capital punishment conflicts with medical and nursing code of ethics preventing providers who are skilled at difficult intravenous (IV) access, assessment of appropriate sedation, and involvement without fear of disciplinary action. Therefore, untrained or undertrained personnel from the prison have been delegated these duties. Cases in which failure to establish or maintain IV access has led to executions lasting up to 90 minutes before the execution was complete. Participation by skilled medical personnel has been a debate between the medical and legal communities since the inception of lethal injection. Healthcare should reevaluate the ethical and moral principle of beneficence as the legal system attempts to evaluate the constitutionality of lethal injection. Can a nurse or doctor step out of the role of medical professional, use knowledge and skill to make death by lethal injection more humane, and not violate the ethical principle of "do no harm"? PMID:19090308

Johnson, Kevin W

2008-12-01

225

Twenty-first Century ethics of medical research involving human subjects: achievements and challenges  

Microsoft Academic Search

The field of ethics in medical research has seen important developments in the last three decades, but it also faces great\\u000a challenges in the new century. The purposes of this report are to examine the current status of ethics of medical research\\u000a involving human subjects and the nature of the ethical challenges facing this research, to identify the weakness of

Antonios H. Tzamaloukas; Konstantin N. Konstantinov; Emmanuel I. Agaba; Dominic S. C. Raj; Glen H. Murata; Robert H. Glew

2008-01-01

226

Ethics education for medical house officers: long-term improvements in knowledge and confidence  

Microsoft Academic Search

OBJECTIVE: To examine the long-term effects of an innovative curriculum on medical house officers' (HOs') knowledge, confidence, and attitudes regarding medical ethics. DESIGN: Long term cohort study. The two-year curriculum, implemented by a single physician ethicist with assistance from other faculty, was fully integrated into the programme. It consisted of monthly sessions: ethics morning report alternating with didactic conferences. The

D P Sulmasy; E S Marx

1997-01-01

227

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

ERIC Educational Resources Information Center

|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.…

Jonsen, Albert R.

1989-01-01

228

Medical Decision and Patient's Preference: 'Much Ethics' and More Trust Always Needed  

PubMed Central

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice.

Anyfantakis, Dimitrios; Symvoulakis, Emmanouil K

2011-01-01

229

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

NASA Astrophysics Data System (ADS)

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.

Montanari, Alberto

2010-05-01

230

Resolving ethical dilemmas in health care: A recommended program for critically analyzing and settling moral conflicts that arise within the practice and delivery of medical care  

Microsoft Academic Search

This dissertation offers a program for critically analyzing and resolving ethical dilemmas that arise within the practice and delivery of medical care. Fundamental principles that ought to ground moral and rational decisions in the doctor-patient relationship will be explored. A recommended model for the doctor-patient interaction will be argued for, including the limits of justified paternalistic interference by the physician.

Marc M. Edelstein

1992-01-01

231

Four approaches to doing ethics.  

PubMed

Within the field of medical ethics there is a startling amount of diversity regarding which issues and relationships are deemed relevant for ethical inquiry and analysis, what strategies are appropriate for examining and resolving ethical conflict, what should be the goals for medical ethics, even who should participate in that project. What I will try to make clear in this paper is that how we go about this process of doing medical ethics, of examining, reflecting, decisionmaking, and behaving, makes a practical difference, and not just a philosophical one, in terms of the understandings we will reach about ethical matters. Without attempting to resolve any of the conflicts within or between different conceptions of doing ethics, I will try to articulate the differences in orientation, and particularly the tone and educational emphasis, that attend four major contemporary approaches to ethical inquiry and analysis: deductivism, principlism, modern casuistry, and feminist/relationist ethics. PMID:8740882

Levi, B H

1996-02-01

232

Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals.  

PubMed

The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions. PMID:17971475

Volandes, Angelo

2007-11-01

233

Ethics and Childbirth Educators: Do Your Values Cause You Ethical Distress?  

PubMed Central

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection.

Ondeck, Michele

2009-01-01

234

Ethics and childbirth educators: do your values cause you ethical distress?  

PubMed

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection. PMID:19436591

Ondeck, Michele

2009-01-01

235

The ethics of the medical-pharmaceutical relationship.  

PubMed

Physician interaction with the pharmaceutical industry raises many ethical concerns. This relationship is complex, owing to a pluralism of beliefs held by physicians, patients, and third parties. As a result, determining whether physicians fulfill their responsibilities to both the professional and public communities is an arduous endeavor. In an effort to clarify the situation and provide transparency to this complex relationship, medical and pharmaceutical organizations have enacted their own respective codes and guidelines. Even with adherence to these guidelines, questions remain regarding the codependent relationship that interweaves the pharmaceutical industry with the medical community. Owing to the ever-changing landscape enmeshing product development, scientific advancement, corporate realities and patient care, the proper choice for physicians is rarely obvious; however, to operate to the highest standards, those in the medical community must be candid about relations with the pharmaceutical industry and transparent in their financial interests. Further undertakings should focus not on the eradication of physician-pharmaceutical interaction, but instead on the education of physicians about industry marketing strategies and the delineation of boundaries of these interactions to benefit not the individual physician, but our patients. PMID:22330662

Vashi, Neelam A; Latkowski, Jo-Ann M

236

Addiction Research Ethics and the Belmont Principles: Do Drug Users Have a Different Moral Voice?  

PubMed Central

This study used semi-structured interviews and content analysis to examine moral principles that street drug users apply to three hypothetical addiction research ethical dilemmas. Participants (n = 90) were ethnically diverse, economically disadvantaged drug users recruited in New York City in 2009. Participants applied a wide range of contextually sensitive moral precepts, including respect, beneficence, justice, relationality, professional obligations, rules, and pragmatic self-interest. Limitations and implications for future research and the responsible conduct of addiction research are discussed.

Fisher, Celia B.

2013-01-01

237

The Good, the Bad, and the Ugly: Ethical Principles for (Re)Presenting Students and Student Writing in Teachers' Publications.  

ERIC Educational Resources Information Center

Addresses interrelated sets of ethical considerations: the ethical principles for representing students and student writing in the teacher's own publications of two types--in textbooks designed for student use, and in research publications and conference presentations designed for the author's peers. Lists 10 points to make clear to students whose…

Bloom, Lynn Z.

2003-01-01

238

Ethical and professional conduct of medical students: review of current assessment measures and controversies  

PubMed Central

As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection and remediation of problems.

Boon, K; Turner, J

2004-01-01

239

Ethical awareness among first year medical, dental and nursing students  

Microsoft Academic Search

Ethics is increasingly being included in the training curriculum for health-care professionals. However, debate continues around the appropriate content of ethics courses for such students and the most relevant teaching approaches which will enable students to apply their ethical knowledge in clinical settings. At a time when health-care professionals are starting to collaborate more closely in multidisciplinary teams, it is

Jane Smith

1995-01-01

240

Computer Assisted Reasoning On Principles And Properties of Medical Physiology  

Microsoft Academic Search

Developing practical tools to aid in understanding medical physiological systems is a formidable undertaking. This paper presents a method that uses a property structure for the domain being investigated. Furthermore, it employs realistic models to present examples of the behavior of the system. From these examples the principles that relate the properties are inferred through the use of genetic algorithm-based

B. Zupan; J. A. Halter; M. Bohanec

241

Medical Students? Cases as an Empirical Basis for Teaching Clinical Ethics  

Microsoft Academic Search

To identify ethical issues that interns encounter in their clinical education and thus build a more empirical basis for the required contents of the clinical ethics curriculum.\\u000aThe authors analyzed a total of 522 required case reports on ethical dilemmas experienced by interns from September 1995 to May 1999 at the medical school of Vrije Universiteit in Amsterdam. They identified

Marli Huijer; Leeuwen van Evert; Annette Boenink; Gerrit Kimsma

2000-01-01

242

The effect of teaching medical ethics on medical students' moral reasoning.  

PubMed

A study assessed the effect of incorporating medical ethics into the medical curriculum and the relative effects of two methods of implementing that curriculum, namely, lecture and case-study discussions. Results indicate a statistically significant increase (p less than or equal to .0001) in the level of moral reasoning of students exposed to the medical ethics course, regardless of format. Moreover, the unadjusted posttest scores indicated that the case-study method was significantly (p less than or equal to .03) more effective than the lecture method in increasing students' level of moral reasoning. When adjustment were made for the pretest scores, however, this difference was not statistically significant (p less than or equal to .18). Regression analysis by linear panel techniques revealed that age, gender, undergraduate grade-point average, and scores on the Medical College Admission Test were not related to the changes in moral-reasoning scores. All of the variance that could be explained was due to the students' being in one of the two experimental groups. In comparison with the control group, the change associated with each experimental format was statistically significant (lecture, p less than or equal to .004; case study, p less than or equal to .0001). Various explanations for these findings and their implications are given. PMID:2590358

Self, D J; Wolinsky, F D; Baldwin, D C

1989-12-01

243

Evaluation of teaching medical ethics by an assessment of moral reasoning.  

PubMed

This study assessed the hypothesis that the formal teaching of medical ethics promotes a significant increase in the growth and development of moral reasoning in medical students. Results indicated a statistically significant increase (P less than or equal to 0.0005) in the level of moral reasoning of students exposed to a medical ethics course compared to the control group that was not exposed to the medical ethics course. When the posttest scores were adjusted by subtracting the pretest scores, the differences were even more significant (P less than or equal to 0.0002). This study confirmed similar findings of another study using a different instrument of assessment. Brief discussion is given of the fundamental premise that the appropriate function of teaching medical ethics in our modern pluralistic society is to improve students' moral reasoning about value issues regardless of what their particular set of moral values happens to be. PMID:1614342

Self, D J; Baldwin, D C; Wolinsky, F D

1992-05-01

244

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

PubMed

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

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

245

Ethics of the allocation of highly advanced medical technologies.  

PubMed

The disproportionate distribution of financial, educational, social, and medical resources between some rich countries of the northern hemisphere and less fortunate societies creates a moral challenge of global dimension. The development of new forms of highly advanced medical technologies, including neoorgans and xenografts, as well as the promotion of health literacy and predictive and preventive medical services might reduce some problems in allocational justice. Most governments and the World Health Organization (WHO) reject financial and other rewards for living organ donors thus indirectly contributing to the development of black markets. A societal gratuity model supporting and safeguarding a highly regulated market between providers and recipients of organs might provide for better protection of those who provide organs not solely based on altruistic reasons. The moral assessment of global issues in allocation and justice in the distribution of medical technologies must be increased and will have to be based on the principles of self determination and responsibility, solidarity and subsidiarity, and respect for individual values and cultural traditions. PMID:9527289

Sass, H M

1998-03-01

246

Medical ethics and truth telling in the case of androgen insensitivity syndrome.  

PubMed Central

Should a physician always tell the truth to a patient? Is biomedical ethics too "politically correct" in certain situations? The second-place winner in the 1995 Logie Medical Ethics Essay Contest discusses whether telling the truth is the proper course for a physician dealing with certain patients. Images p569-a

Natarajan, A

1996-01-01

247

Medical students' evaluation of their exposure to the teaching of ethics  

PubMed Central

Background: The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students. Objectives: (1) To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). (2) To explore the perception of medical students on the different components of the course. Materials and Methods: The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course. Results: Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics. Conclusion: The students provided valuable comments that were supported by the literature reviews. Medical Students’ views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum.

Al-Haqwi, Ali I.; Al-Shehri, Ali M.

2010-01-01

248

Initiatives by the government and physician groups to improve awareness of medical ethics: Challenges in Japan  

PubMed Central

Physicians have been required to possess high ethical standards, as medical practice is directly involved with patients' lives. Although ethics arise out of an individual's consciousness, ethical regulations imposed by the nation/government together with self-regulation by physician groups are important in the practice of ethics, for which reason countries around the world undertake various initiatives. This paper investigates physician licensure, organizations governing physician status, the role of physician groups, and the actual conditions of lifelong learning and ethics education in developed countries worldwide, in contrast with which it throws problems in the situation in Japan into relief. Organizations governing physician status, the form of medical associations, and the improvement of lifelong learning are pointed out as critical issues especially in Japan.

MORIOKA, Yasuhiko

2012-01-01

249

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

PubMed

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

Baker, Robert; McCullough, Laurence

2007-03-01

250

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans  

PubMed Central

Background: Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. Method: We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998–99 policies of 38 organisations—18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)—selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. Results: A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. Conclusions: With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery.

Berkman, N; Wynia, M; Churchill, L

2004-01-01

251

Preoperative Medical Evaluation: Part 1: General Principles and Cardiovascular Considerations  

PubMed Central

A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to use sedation or general anesthesia as an adjunct to dental treatment. This article is the first of a 2-part sequence and will address general principles and cardiovascular considerations. A second article will address pulmonary, metabolic, and miscellaneous disorders.

Becker, Daniel E

2009-01-01

252

The new military medical ethics: legacies of the Gulf Wars and the War on Terror.  

PubMed

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990-1991) and the War on Terror (2001-). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a 'new kind of war'. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency. PMID:21752039

Miles, Steven H

2011-07-13

253

Teaching medical ethics to undergraduate students in post-apartheid South Africa, 2003-2006  

PubMed Central

The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country.

Moodley, Keymanthri

2007-01-01

254

Aligning ethics with medical decision-making: the quest for informed patient choice.  

PubMed

Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: (1) create model integration programs; (2) provide legal incentives to ease the transition; and (3) incorporate shared decision-making into medical necessity determinations. PMID:20446987

Moulton, Benjamin; King, Jaime S

2010-01-01

255

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

PubMed

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

1989-01-01

256

Dismembering the ethical physician  

PubMed Central

Physicians may experience ethical distress when they are caught in difficult clinical situations that demand ethical decision making, particularly when their preferred action may contravene the expectations of patients and established authorities. When principled and competent doctors succumb to patient wishes or establishment guidelines and participate in actions they perceive to be ethically inappropriate, or agree to refrain from interventions they believe to be in the best interests of patients, individual professional integrity may be diminished, and ethical reliability is potentially compromised. In a climate of ever?proliferating ethical quandaries, it is essential for the medical community, health institutions, and governing bodies to pursue a judicious tension between the indispensable regulation of physicians necessary to maintain professional standards and preserve public safety, and the support for “freedom of conscience” that principled physicians require to practise medicine in keeping with their personal ethical orientation.

Genuis, S J

2006-01-01

257

Ethical sensitivity and the goals of medicine: resisting the tides of medical deprofessionalisation.  

PubMed

There is a growing concern that, like in many developed countries, medical practice in Singapore is fast losing its role and status as a profession. The commodification and industrialisation of health care, and weakening of its ethical foundations are among the main forces threatening to deprofessionalise the practice of medicine. To overcome these challenges, an honest and introspective review of the goals of medicine and an affirmation of the ethical values of medicine are needed in order to reinstate the unique role of medicine in our society. Important steps to take include adopting a patient-centred philosophy and practice culture, promoting and emphasising ethical awareness and sensitivity among physicians, and active participation in constructive dialogues to negotiate the social contract of the profession. A more permanent impact may be achieved through cultivation of medical virtues in physicians, and the integration of core elements of medical professionalism into the ethical systems and mission statement of today's health care organisations. PMID:11989582

Chin, J J

2001-12-01

258

Ethical Expert Systems  

PubMed Central

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.

Victoroff, Michael S.

1985-01-01

259

Medical travel and the sale of human biological materials: Suggestions for ethical policy development  

Microsoft Academic Search

The international medical travel industry includes patients seeking to access human biological materials (HBM) including gametes, organs and stem cells. Of the various niche markets, ‘transplant tourism’ has earned global condemnation and efforts to eradicate cross-border trade in organs, while other markets continue to expand. This article reviews the ethical issues raised by medical travel for HBM, in particular those

Dominique Martin

2010-01-01

260

Addressing ethical considerations and authors' conflict of interest disclosure in medical journals in Iran.  

PubMed

The purpose of this study was to examine how ethical approval and competing interests are addressed by medical journals in Iran. In a cross-sectional study, 151 journals accredited by the Publications Commission of the Ministry of Health and Medical Education were reviewed. Data collection was carried out by assessing journal guidelines and conducting structured phone interviews with journal managers, focusing on how ethical considerations and conflicts of interest (COI) are addressed. Overall, 135 of the 151 journals (89.4 percent) examined some aspect of ethical considerations of submitted articles. Authors were required to disclose their financial sponsors by 98 journals (64.9 percent), while COI disclosure was required by 67 journals (44.4 percent). We conclude that the rate of addressing ethical considerations is not far from ideal, but the requirement for COI disclosure needs more attention. PMID:23188405

Heidari, Akram; Adeli, Seyyed Hassan; Mehravaran, Shiva; Asghari, Fariba

2012-10-25

261

Principlism and moral dilemmas: a new principle  

PubMed Central

Moral conflicts occur in theories that involve more than one principle. I examine basic ways of dealing with moral dilemmas in medical ethics and in ethics generally, and propose a different approach based on a principle I call the "mutuality principle". It is offered as an addition to Tom Beauchamp and James Childress' principlism. The principle calls for the mutual enhancement of basic moral values. After explaining the principle and its strengths, I test it by way of an examination of three responses—in the recent Festschrift for Dr Raanon Gillon—to a case involving parental refusal of a blood transfusion. The strongest response is the one that comes closest to the requirements of the mutuality principle but yet falls short. I argue that the mutuality principle provides an explicit future orientation in principlism and gives it greater moral coherence.

DeMarco, J

2005-01-01

262

Partnership as an ethical model for medical research in developing countries: the example of the “implementation trial”  

Microsoft Academic Search

The existing model for ethical review of medical research consists primarily of regulations designed to prevent exploitation of participants. This model may fail when reviewing other ethical obligations, particularly the responsibility to provide valuable knowledge to society. Such failure is most apparent in developing countries, in which many stakeholders lack incentives or power to uphold society’s interests. An alternative ethical

D W Dowdy

2006-01-01

263

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

PubMed

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

Kidd, Ian James

2012-09-01

264

Activities of an ethics consultation service in a Tertiary Military Medical Center.  

PubMed

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center. PMID:10920652

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

265

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

PubMed Central

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.

2010-01-01

266

[Basic principles of risk management in medical practice].  

PubMed

I explain the basic principles of risk management in medical practice. It is most important to understand the different meanings of the following four terms: risk, danger, crisis, and hazard. The word "risk" comes from Latin, and means food necessary to live today and tomorrow. Both medical practitioners and patients need to get over the risk in the process of diagnosis and treatment. The word "danger" means something which can harm us. It is better not to provoke such dangerous things. The word "crisis" comes from Greek, and signifies a turning point meaning life or death. Decision making is the most important at this critical point. The word "hazard" comes from old French for a game of dice. It may lead to an accident in some situations. The social welfare system has continually deteriorated in Japan. We must provide medical services in unsafe circumstances. Medical practitioners promise to do their best, but cannot guarantee a favorable outcome. It is very important to communicate with patients and family members. Doctors and nurses may experience problems with patients and their families. When problems occur regarding a patient, the management of the hospital must support the staff members concerned. PMID:19363994

Karasawa, Hideharu

2009-03-01

267

Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference  

Microsoft Academic Search

The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in\\u000a medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care.\\u000a This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and\\/or avoiding wait times for\\u000a care in the patient’s

Jeremy Snyder; Valorie Crooks; Leigh Turner

2011-01-01

268

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

PubMed Central

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.

Persaud, R D

1991-01-01

269

Genetic screening; Medical promise amid legal and ethical questions  

Microsoft Academic Search

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

1989-01-01

270

The medical community's opposition to organ markets: Ethics or economics?  

Microsoft Academic Search

A severe shortage of cadaveric human organs for transplantation exists in the U.S. The obvious cause of this shortage is our current public policy which proscribes payment for such organs. Support for this policy and opposition to the formation of organ markets has been quite strong among transplant suppliers (both hospital and physician groups). This paper critically evaluates the ethical

A. H. Barnett; T. Randolph Beard; David L. Kaserman

1993-01-01

271

Oocyte donation in postmenopausal women: medical and ethical considerations  

Microsoft Academic Search

Although maternal morbidity is increased, reported perinatal outcomes from peri- and postmenopausal pregnancy are generally good. Ethical considerations, in particular those relating to long term wellbeing of the child, constitute the primary reason to restrict the use of donated eggs in postmenopausal women.

M. Kortman; N. S. Macklon

2008-01-01

272

Difficult Decisions: Social and Ethical Implications of Changing Medical Technology  

Microsoft Academic Search

Objectives: A primary objective of this paper is to present data on subjective perceptions of health and quality of life in individuals living with early- or late-onset genetic conditions (cystic fibrosis, CF, and Huntington’s disease, HD, respectively). The paper will also discuss the social and ethical dilemmas raised by advances in reproductive and testing technology, consider the different emphases in

Elizabeth Chapman

2002-01-01

273

Medical Ethics and the Interrogation of Guantanamo 063  

Microsoft Academic Search

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

Steven H. Miles

2007-01-01

274

Changing ethics in medical practice: a Thai perspective.  

PubMed

The pace of social change in Thailand has seen the rise of various medical services and a global clientele. Currently, medical tourism and cosmetic surgery have an important role in medical practice here. A growing medical market offers a range of services at competitive rates and high levels of efficiency. This essay provides an overview of medical practices in Thailand and their effect on ordinary people. PMID:18630216

Saniotis, Arthur

275

Enhancing Cross-Cultural Understandings of Ethical Issues in Medical Education  

Microsoft Academic Search

The four principles approach (principlism) is widely implemented in medical curricula. However, there is ongoing debate about the “universality” of this approach. A frequent criticism is that principlism reflects Western ideals such as the importance of individual rights. Some Asian scholars have argued that Asian bioethics is essentially different from Western approaches. This paper reports on a qualitative study investigating

G. Fuscaldo; S. Russell; C. Delany

2010-01-01

276

Multidisciplinary teaching in a formal medical ethics course for clinical students.  

PubMed

A successful feature of the 4th-year curriculum in the Medical Faculty of the Queen's University, Belfast has been the development of interdisciplinary teaching in a three-week joint course to which several clinical departments contribute...Co-ordinated teaching of topics of common interest in small groups included, until the academic year 1987/88, a three-hour session on medical ethics. In the spring of 1987 the authors approached the Department of Philosophy at Queen's; subsequently proposals for a formal multidiscipinary course in medical ethics for 4th-year clinical students in the Medical Faculty, for the academic year 1987/88, were approved by the Education Committee of the Medical Faculty. PMID:11650820

Irwin, W G; McClelland, R J; Stout, R W; Stchedroff, M

1988-09-01

277

[Ethical consequences of the diagnosis of psychosis].  

PubMed

Psychosis is defined by the loss of reality testing. Apart from that, it is rather broadly and vaguely defined. Ethics is the art of defining what is right and what is wrong. Medical ethics apply a diversity of ethical principles to a complex clinical reality after discussion and consideration. In forensic psychiatry the diagnosis of psychosis has vast ethical implications. In the Danish law on psychiatry conditions for coercion and involuntary treatment are stated, and in the law on penalty the principle of treatment instead of penalty is stated. Thus, implications for diagnoses and treatment go far beyond other medical diagnoses. PMID:22369904

Lindhardt, Anne

2012-02-27

278

Ethics and observational studies in medical research: various rules in a common framework  

PubMed Central

Background Research ethics have become universal in their principles through international agreements. The standardization of regulations facilitates the internationalization of research concerning drugs. However, in so-called observational studies (i.e. from data collected retrospectively or prospectively, obtained without any additional therapy or monitoring procedure), the modalities used for applying the main principles vary from one country to the other. This situation may entail problems for the conduct of multi-centric international studies, as well as for the publication of results if the authors and editors come from countries governed by different regulations. In particular, several French observational studies were rejected or retracted by United States peer reviewed journals, because their protocols have not been submitted to an Institutional Review Board/Independent Ethics Committee (IRB/IEC). Methods national legislation case analysis Results In accordance with European regulation, French observational studies from data obtained without any additional therapy or monitoring procedure, do not need the approval of an IRB/IEC. Nevertheless, these researches are neither exempt from scientific opinion nor from ethical and legal authorization. Conclusion We wish to demonstrate through the study of this example that different bodies of law can provide equivalent levels of protection that respect the same ethical principles. Our purpose in writing this paper was to encourage public bodies, scientific journals, and researchers to gain a better understanding of the various sets of specific national regulations and to speak a common language.

Claudot, Frederique; Alla, Francois; Fresson, Jeanne; Calvez, Thierry; Coudane, Henry; Bonaiti-Pellie, Catherine

2009-01-01

279

A physician-driven solution--the Association for Medical Ethics, the Physician Payment Sunshine Act, and ethical challenges in pain medicine.  

PubMed

The practice of contemporary pain medicine is laced with a number of significant ethical challenges. Considerable difficulties include the overutilization of interventional procedures, the application of under-evidenced treatment modalities, and potentially superfluous opioid prescribing. As with many other fields in medicine, including orthopedic surgery, relationships with industry are both common and pervasive, and influence our medical practice through education, publications, and research. This article highlights these ethical challenges and broaches several physician-driven solutions: The Association for Medical Ethics, the Physicians Payment Sunshine inspired by it, and other non-legislative reforms are discussed. PMID:21914121

Perret, Danielle; Rosen, Charles

2011-09-01

280

Helping medical students to find their moral compasses: ethics teaching for second and third year undergraduates.  

PubMed

The paper describes a two week course that has been offered as a special study module to intermediate level (second and third year) undergraduate medical students at Dundee University Medical School for the past five years. The course requires students to research the various aspects of ethical dilemmas that they have identified themselves, and to "teach" these issues to their colleagues in a short PowerPoint presentation as well as to prepare an extended 3000 word essay discussion. The course specifically asks students not to disclose their own ethical positions, as these are probably still in formation and the objective is to promote critical thinking capacity in ethical and moral issues as a prelude to the development of practical skills in dealing with clinical problems. The course is easy to resource for the school and has received universally high evaluations from the students since its inception. PMID:15467084

Roff, S; Preece, P

2004-10-01

281

How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views  

PubMed Central

Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative impact. Therefore the teaching of GTE should already begin in the 1st semester. The teaching of GTE must take into account that even right at the start of their studies, students judge medical ethics and the history of medicine differently.

Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schafer, Thorsten

2012-01-01

282

Students' Conceptions of Underlying Principles in Medical Physiology: An Interview Study of Medical Students' Understanding in a PBL Curriculum  

ERIC Educational Resources Information Center

|Medical physiology is known to be a complex area where students develop significant errors in conceptual understanding. Students' knowledge is often bound to situational descriptions rather than underlying principles. This study explores how medical students discern and process underlying principles in physiology. Indepth interviews, where…

Fyrenius, Anna; Silen, Charlotte; Wirell, Staffan

2007-01-01

283

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

ERIC Educational Resources Information Center

|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…

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

2006-01-01

284

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

ERIC Educational Resources Information Center

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…

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

2006-01-01

285

Medical and ethical considerations in twin pregnancies discordant for serious cardiac disease  

Microsoft Academic Search

Objective:Prenatal ultrasound has led to the early diagnosis of major anomalies. However, the ready availability of this technology has led to increasing challenges for physicians counseling affected parents, which is all the more difficult in a twin pregnancy with only one affected fetus. This paper reviews the medical and ethical considerations in twin pregnancies discordant for a serious cardiac condition.Study

A Malhotra; S Menahem; P Shekleton; L Gillam

2009-01-01

286

Ethics and law in the field of medical care for the elderly in France  

Microsoft Academic Search

The authors discuss law and ethics when medical decisions are to be taken by patients who are unable in any valid sense to express their own wishes. The main problem in legal terms is to protect an individual's free will as far as possible and ensure that his or her wishes, if known, are respected. If a patient's independent wishes

S Gromb; G Manciet; A Descamps

1997-01-01

287

Laying medicine open: understanding major turning points in the history of medical ethics.  

PubMed

At different times during its history medicine has been laid open to accountability for its scientific and moral quality. This phenonmenon of laying medicine open has sometimes resulted in major turning points in the history of medical ethics. In this paper, I examine two examples of when the laying open of medicine has generated such turning points: eighteenth-century British medicine and late twentieth-century American medicine. In the eighteenth century, the Scottish physician-philosopher, John Gregory (1724-1773), concerned with the unscientific, entrepreneurial, self-interested nature of then current medical practice, laid medicine open to accountability using the tools of ethics and philosophy of medicine. In the process, Gregory wrote the first professional ethics of medicine in the English-language literature, based on the physician's fiduciary responsibility to the patient. In the late twentieth century, the managed practice of medicine has laid medicine open to accountability for its scientific quality and economic cost. This current laying open of medicine creates the challenge of developing medical ethics and bioethics for population-based medical science and practice. PMID:11657315

McCullough, Laurence B

1999-03-01

288

Ethics: It Is Time to Add a Thirteenth Principle of War.  

National Technical Information Service (NTIS)

Today, U.S. military forces operate in an extremely challenging operational environment that requires an enhanced understanding and application of ethics. In this regard, ethics is even more important at the operational and tactical levels, across the ful...

P. Timoney

2008-01-01

289

Narrative Ethics as Collaboration: A Four-Session Curriculum  

Microsoft Academic Search

The traditional model of medical ethics minimizes the particular, ever-changing, concrete realities of patients’ lives in favor of general, invariable, abstract principles. Narrative ethics offers a powerful complement to that model. Focused on each patient’s life story, as told by the patient and family members, it helps residents to understand how social location structures ethical dilemmas. As well, it demonstrates

Thelma Jean Goodrich; Craig A. Irvine; Daria Boccher-Lattimore

2005-01-01

290

When Relatives and Friends Ask Physicians for Medical Advice: Ethical, Legal, and Practical Considerations  

Microsoft Academic Search

Physicians often are asked for advice about medical matters by relatives and friends. These range from requests for simple\\u000a information to requests for medical opinion and judgment and more substantial involvement by the physician. I comment on the\\u000a motivations and expectations of the requester and the physician, and the legal, ethical, and practical considerations related\\u000a to such requests. I recommend:

Gregory L. Eastwood

2009-01-01

291

Empirical research in medical ethics: How conceptual accounts on normative-empirical collaboration may improve research practice  

PubMed Central

Background The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. Discussion A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. Summary High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis.

2012-01-01

292

[Can we take for granted medical progress without progress in ethics?].  

PubMed

Since the mid 20th century progress in biomedical science has been punctuated by the emergence of bioethics which has fashioned the moral framework of its application to both research and clinical practice. Can we, however, consider the advent of bioethics as a form of progress marking the advances made in biomedical science with an adequate ethical stamp? The argument put forward in this chapter is based on the observation that, far from being a mark of progess, the development of bioethics runs the risk of favouring, like modern science, a dissolution of the links that unite ethics and medicine, and so of depriving the latter of the humanist dimensions that underlie the responsibilities that fall to it. Faced with this possible pitfall, this contribution proposes to envisage as a figure of moral progress, consubstantial with the development of biomedical science, an ethical approach conceived as a means of social intervention which takes the first steps towards an ethics of responsibility integrating the bioethical perspective within a hermeneutic and deliberative approach. By the yardstick of a prudential approach, it would pay particular attention to the diverse sources of normativity in medical acts. It is suggested that this ethical approach is a source of progress insofar as it constitutes an indispensable attitude of watchfulness, which biomedical science can lean on as it advances, with a view to ensuring that the fundamental link uniting ethics and medicine is maintained. PMID:23991542

Benaroyo, Lazare

293

Evaluating ethical sensitivity in medical students: using vignettes as an instrument.  

PubMed Central

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured.

Hebert, P; Meslin, E M; Dunn, E V; Byrne, N; Reid, S R

1990-01-01

294

Medical\\/legal\\/ethical aspects of cesarean section  

Microsoft Academic Search

No single topic in obstetrics is more controversial these days than that of Cesarean delivery. Although much of the discussion centers around the issues of vaginal birth after Cesarean section and the associated informed consent, there are other significant medical\\/legal aspects to consider. Both women who refuse medically-recommended Cesarean delivery as well as those who demand seemingly unwarranted Cesarean section,

C. C. Coulson; J. M. Cain

1999-01-01

295

Biotechnology and ethics in medical education of the new millennium: physician roles and responsibilities.  

PubMed

Although the medical education curriculum varies internationally, we suggest that it is desirable for medical educators to share a universal responsibility to prepare physicians to perform three distinct, yet interrelated professional roles. The first is that of a clinician who has the knowledge and technical skills to care for individual patients, as well as the public. The second role can be viewed as that of an educator, a teacher, or a consultant who has the interpersonal skills and personal qualities to teach, advise and counsel patients and the public about their health and illness, risk factors and healthy lifestyle. The third role is that of a resource manager to enable physicians to care for patients and serve the public not only by drawing on available material assets but also by prudent use of the resources for better serving the most number of people at the least expense without compromising the quality of care. The very nature of the medical profession also obligates medical educators through the world to sensitize medical students and physicians to the ethical responsibilities that are implicit to each of the three aforementioned roles. Although the basic ethical responsibilities of do no harm and confidentiality are universal, certain global changes, such as rapid advancements in biotechnology and resource allocation, are now reshaping medical ethics on every continent. Spawned by the rapid advances in the biomedical sciences, biotechnology is revolutionizing human reproduction, sustaining human life, cloning human beings, and mapping the entire human genetic terrain. These advances imply changes in medical education and formal preparation of physicians in performing their roles as clinicians, educators and resource managers. These biotechnological developments, coupled with the increasing cost of healthcare and maldistribution of resources worldwide, present unprecedented ethical-social challenges that need to be addressed in the education of the physician in the new millennium. PMID:12098384

Gonnella, Joseph S.; Hojat, Mohammadreza

2001-07-01

296

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

PubMed Central

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

Weindling, P.

1996-01-01

297

[Medical use of fetal cells and tissue: ethical aspects].  

PubMed

After considering the moral status of the living and of the dead human fetus, the article examines various ethical arguments connected with the use of fetal remains following elective abortion: financial or humanitarian incentives for the termination of pregnancy, conflicts of interest between mother and user, authority over fetal remains and modality of donation and utilization of the fetus. To prevent improper use of fetal remains it is recommended: to separate completely the decisions relating to abortion (first) and to the subsequent use of fetal tissues (second); to obtain explicit informed consent from the mother, making it impossible for her to direct any specific use of the fetal tissues; to base decisions on the method and timing of an abortion on the mother's health care needs alone; to exclude those involved in the process of abortion from any use of the fetus; to protect the anonymity of donor and recipient through an intermediary (tissue bank). PMID:1604879

Wolff, H P

1992-04-01

298

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

PubMed

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

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

299

Terrorism and the ethics of emergency medical care  

Microsoft Academic Search

The threat of domestic and international terrorism involving weapons of mass destruction–terrorism (WMD-T) has become an increasing public health concern for US citizens. WMD-T events may have a major effect on many societal sectors but particularly on the health care delivery system. Anticipated medical problems might include the need for large quantities of medical equipment and supplies, as well as

Nicki Pesik; Mark E. Keim; Kenneth V. Iserson

2001-01-01

300

U.S. medical students' knowledge about the military draft, the Geneva Conventions, and military medical ethics.  

PubMed

The objective of this study was to ascertain how much U.S. medical students are taught about and know about military medical ethics, the Geneva Conventions, and the laws governing conscription of medical personnel. The authors developed an Internet-based questionnaire on these matters, and e-mail invitations to participate were sent to approximately 5,000 medical students at eight U.S. medical schools. Thirty-five percent of e-mail recipients participated in the survey. Of those, 94 percent had received less than one hour of instruction about military medical ethics and only 3.5 percent were aware of legislation already passed making a "doctor's draft" possible; 37 percent knew the conditions under which the Geneva Conventions apply; 33.8 percent did not know that the Geneva Conventions state that physicians should "treat the sickest first, regardless of nationality;" 37 percent did not know that the Geneva Conventions prohibit ever threatening or demeaning prisoners or depriving them of food or water; and 33.9 percent could not state when they would be required to disobey an unethical order. PMID:18072313

Boyd, J Wesley; Himmelstein, David U; Lasser, Karen; McCormick, Danny; Bor, David H; Cutrona, Sarah L; Woolhandler, Steffie

2007-01-01

301

Regulating Human Participants Protection in Medical Research and the Accreditation of Medical Research Ethics Committees in the Netherlands  

Microsoft Academic Search

The review system on research with human participants in the Netherlands is characterised as a decentralised controlled and\\u000a integrated peer review system. It consists of an independent governmental body, the Central Committee on Research Involving\\u000a Human Subjects (or Central Committee), which regulates the review of research proposals by accredited Medical Research Ethics\\u000a Committees (MRECs). The legal basis was founded in

Marcel J. H. Kenter

2009-01-01

302

The Principle of Caveat Emptor: Confidentiality and Informed Consent as Endemic Ethical Dilemmas in Focus Group Research  

Microsoft Academic Search

Informed consent and confidentiality supposedly minimize harm for research participants in all qualitative research methodologies,\\u000a inclusive of one-on-one unstructured interviews and focus groups. This is not the case for the latter. Confidentiality and\\u000a informed consent uniquely manifest themselves as endemic ethical dilemmas for focus group researchers. The principle of caveat\\u000a emptor (let the buyer beware) may be a more useful

Martin Tolich

2009-01-01

303

Ethics, privacy and the legal framework governing medical data: opportunities or threats for biomedical and public health research?  

PubMed

Privacy is an important concern in any research programme that deals with personal medical data. In recent years, ethics and privacy have become key considerations when conducting any form of scientific research that involves personal data. These issues are now addressed in healthcare professional training programmes. Indeed, ethics, legal frameworks and privacy are often the subject of much confusion in discussions among healthcare professionals. They tend to group these different concepts under the same heading and delegate responsibility for "ethical" approval of their research programmes to ethics committees. Public health researchers therefore need to ask questions about how changes to legal frameworks and ethical codes governing privacy in the use of personal medical data are to be applied in practice. What types of data do these laws and codes cover? Who is involved? What restrictions and requirements apply to any research programme that involves medical data? PMID:23799934

Coppieters, Yves; Levêque, Alain

2013-06-21

304

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

PubMed

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

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

2013-04-17

305

Simulation-Based Medical Education: An Ethical Imperative.  

ERIC Educational Resources Information Center

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)

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

2003-01-01

306

Bioethics for Clinicians: 10. Research Ethics  

Microsoft Academic Search

Medical research involving human subjects raises complex ethical, legal and social issues. Investigators sometimes find that their obligations with respect to a research project come into conflict with their obligations to individual patients. The ethical conduct of research rests on 3 guiding principles: respect for persons, beneficience, and justice. Respect for persons underlies the duty to obtain informed consent from

Charles Weijer; Bernard Dickens; Eric M. Meslin

1997-01-01

307

Attitudes towards terminal sedation: an empirical survey among experts in the field of medical ethics  

PubMed Central

Background "Terminal sedation" regarded as the use of sedation in (pre-)terminal patients with treatment-refractory symptoms is controversially discussed not only within palliative medicine. While supporters consider terminal sedation as an indispensable palliative medical treatment option, opponents disapprove of it as "slow euthanasia". Against this background, we interviewed medical ethics experts by questionnaire on the term and the moral acceptance of terminal sedation in order to find out how they think about this topic. We were especially interested in whether experts with a professional medical and nursing background think differently about the topic than experts without this background. Methods The survey was carried out by questionnaire; beside the provided answering options free text comments were possible. As test persons we chose the 477 members of the German Academy for Ethics in Medicine, an interdisciplinary society for medical ethics. Results 281 completed questionnaires were returned (response rate = 59%). The majority of persons without medical background regarded "terminal sedation" as an intentional elimination of consciousness until the patient's death occurs; persons with a medical background generally had a broader understanding of the term, including light or intermittent forms of sedation. 98% of the respondents regarded terminal sedation in dying patients with treatment-refractory physical symptoms as acceptable. Situations in which the dying process has not yet started, in which untreatable mental symptoms are the indication for terminal sedation or in which life-sustaining measures are withdrawn during sedation were evaluated as morally difficult. Conclusion The survey reveals a great need for research and discussion on the medical indication as well as on the moral evaluation of terminal sedation. Prerequisite for this is a more precise terminology which describes the circumstances of the sedation.

Simon, Alfred; Kar, Magdalene; Hinz, Jose; Beck, Dietmar

2007-01-01

308

Emergency department triage: an ethical analysis  

PubMed Central

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.

2011-01-01

309

Medical Biotechnologies: Are There Effective Ethical Arguments for Policy Making?  

Microsoft Academic Search

\\u000a The intensity of moral controversy over the development of groundbreaking medical biotechnologies can hardly be overstated.1 Studies conducted by scientists in genetics, cloning, and stem-cell research have often become the news headlines that are\\u000a not only exciting but also disquieting. On the one hand, by gaining new knowledge and technologies in areas such as genetic\\u000a engineering or stem-cell therapy, biomedical

Ruiping Fan; Erika Yu

310

The ethics of everyday practice in primary medical care: responding to social health inequities  

PubMed Central

Background Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities. Results Some see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either. Conclusion This paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision.

2010-01-01

311

Ethical Principles and Standards that Inform Educational Gatekeeping Practices in Psychology  

Microsoft Academic Search

Educational gatekeeping functions in psychology serve to assess, remediate, and\\/or dismiss students and trainees with problematic professional competencies (STPPC). Recently, professional psychology graduate programs have increasingly focused on problems with professional competency, and they have begun to implement formal procedures to intervene with STPPC (Rubin et al., 2007). However, there has been considerably less literature addressing the ethics and ethical

Kimberly E. Bodner

2012-01-01

312

From responsible management to responsible organizations; the democratic principle for managing organizational ethics  

Microsoft Academic Search

An increasing number of organizations have adopted formal ethics programs. Almost all of these programs are institutionalized at a corporate level and based on communication with representatives and on hierarchical regulations. Sociotechnical theory suggests the use of a participative approach for managing ethics in an organization. In this approach, employees and other stakeholders are directly involved in setting the norms,

Maarten J. Verkerk; Leede de Jan; André H. J. Nijhof

2001-01-01

313

In search of the soul in science: medical ethics' appropriation of philosophy of science in the 1970s.  

PubMed

This paper examines the deployment of science studies within the field of medical ethics. For a short time, the discourse of medical ethics became a fertile ground for a dialogue between philosophically minded bioethicists and the philosophers of science who responded to Thomas Kuhn's challenge. In their discussion of the validity of Kuhn's work, these bioethicists suggested a distinct interpretation of Kuhn, emphasizing the elements in his account that had been independently developed by Michael Polanyi, and propelling a view of science that retreated from idealizations of scientific method without sacrificing philosophical realism. Appropriating Polanyi, they extended his account of science to biology and medicine. The contribution of Karl Popper to the debate on the applicability of philosophy of science to the issues of medical ethics provides the opportunity to discuss the ways in which political agendas of different epistemologies of science intertwined with questions of concern to medical ethics. PMID:19835265

Aronova, Elena

2009-01-01

314

Avoiding bias in medical ethical decision-making. Lessons to be learnt from psychology research  

Microsoft Academic Search

When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the\\u000a course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients,\\u000a their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning\\u000a may be affected by undesired influences that may undermine

Heidi Albisser Schleger; Nicole R. Oehninger; Stella Reiter-Theil

2011-01-01

315

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

PubMed

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

1996-08-01

316

Congenital rubella syndrome: seeking damages to be born. Ethical, medical and public health considerations.  

PubMed

A case of congenital rubella syndrome has been the reason to seek damages but a Civil Court of Rome sentenced against this and in favor of sued doctors. We discussed the high level of social attention and the feeling present in our western culture behind the request for damages. Legal considerations above the Italian abortion Law is provided to understand the framework of the court decision. Ethical, medical, and public health issues are commented and compared with the Perruche's case. PMID:21231850

Verghini, Emanuele; Di Pietro, Maria Luisa; Virdis, Andrea; De Luca, Daniele

2011-01-13

317

[The paramedical approach and medical ethics (author's transl)].  

PubMed

The fundamentally different approaches of modern science-based medicine and of those magic diagnostic and therapeutic procedures like iridiagnosis anthroposophical medicine, homeopathy, cell-therapy, neural-therapy, magnetic therapy and others, are analysed. Science-based medicine relies on the rules of the principle of causality, reproducibility, and predictability of its results, supported by its success. The dangers of modern medicine are its rationality and factualness which the doctor has to adapt individually to each patient. Otherwise he renders the patient susceptible to paramedical methods which make use of his suggestibility and need for comfort and consolation. Nothing is to be said against these methods as long as they are used as a psychotherapeutic vehicle, do no harm, and do not exploit the patient economically. If that would be the case, the patient must be protected against such quackery. PMID:6278299

Ewerbeck, H

1982-02-01

318

Medical students' recognition and application of geriatrics principles in a new curriculum.  

PubMed

Given the aging U.S. population, it is imperative that medical students recognize and apply geriatrics principles. To address this need, in 2006, the Warren Alpert Medical School of Brown University integrated geriatrics content into a new medical school curriculum. Preclinical and clinical medical students submitted written reflective journals in response to prompts regarding the geriatrics content of the new medical school curriculum, including their didactic and clinical experiences. An interdisciplinary team used a structured qualitative approach to identify themes, including the recognition and application of geriatrics principles. Thirty medical student journalers submitted 405 journal entries. Themes regarding students' emerging understanding of geriatrics principles included a growing understanding of geriatrics principles, recognition of the importance of psychosocial factors and patient preferences in caring for older adults, recognition of the complexities of treating older adults and application of geriatric principles to clinical situations, and understanding of physicians' roles in managing the care of older adults. Medical student reflective journaling allows medical educators to obtain timely feedback on curricular innovations and helps illuminate the process by which medical students learn to recognize and apply core geriatrics principles. PMID:23379444

Nanda, Aman; Farrell, Timothy W; Shield, Renée R; Tomas, Maria; Campbell, Susan E; Wetle, Terrie

2013-02-04

319

Teaching medical students on the ethical dimensions of human rights: meeting the challenge in South Africa.  

PubMed Central

SETTING: Previous health policies in South Africa neglected the teaching of ethics and human rights to health professionals. In April 1995, a pilot course was run at the University of Cape Town in which the ethical dimensions of human rights issues in South Africa were explored. OBJECTIVES: To compare knowledge and attitudes of participating students with a group of control students. DESIGN: Retrospective cohort study. SUBJECTS: Seventeen fourth-year medical students who participated in the course and 13 control students from the same class, matched for gender. INTERVENTIONS: Students participated in a one-week module on ethics and human rights. Five months after the course had been run, students completed a semi-structured questionnaire exploring their knowledge and attitudes with regards to ethics and human rights issues. MAIN OUTCOME MEASURES: Knowledge scores, attitude scores and various individual indicators of attitude. RESULTS: Clear benefits for overall knowledge score, for four out of five individual knowledge questions and for one of the attitude questions, were demonstrated. Participating students also appeared to be more convinced of the need for teaching on the ethical dimensions of human rights at postgraduate level and that such teaching should also be integrated in the curriculum. The low response rate amongst controls may have selected students who were more socially conscious, thereby leading to an underestimate of the true impact of the course. CONCLUSION: The evaluation indicates clear benefits of the course for undergraduate students, and supports arguments for the inclusion of such courses in the training of health professionals. This is particularly important given the challenges posed by the Truth and Reconciliation Commission to the health professions to address past complicity in human rights abuses through reorientation of medical training in South Africa.

London, L; McCarthy, G

1998-01-01

320

Ethical Dilemmas in Surgical Critical Care  

Microsoft Academic Search

There are some specific ethical issues related to surgery as an operative discipline. However, in surgical critical care or\\u000a intensive care the ethical issues are quite similar to other medical specialties. First, I will review some general ethical\\u000a principles in patient care, going back to Aristotle and Hippocrates, and proceed to the problems of the modern era, i.e. since\\u000a during

A. E. Baue

321

Paradoxical traps in therapeutics: some dilemmas in medical ethics.  

PubMed Central

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.

Lowental, U

1979-01-01

322

The ethics of medical involvement in torture: commentary  

PubMed Central

Torture does need to be defined if we are to know exactly what we are seeking to ban; but no single definition will do, because there are many possible ones, and we may want to treat different practices that might be called torture differently. Compare the case of homicide; we do not want to punish manslaughter as severely as murder, and may not want to punish killing in self-defence at all. There are degrees of torture as of murder. Unclarities simply play into the hands of would-be torturers. Downie is unsuccessful in deriving the duty of doctors not to be involved in torture from an analysis of the word `doctor'. It may be contrary to the role-duty of doctors to participate in torture; but there might be other duties which overrode this role-duty. The right approach is to ask what principles for the conduct of doctors have the highest acceptance-utility, or, as Kant might have equivalently put it, what the impartial furtherance of everyone's ends demands. This approach yields the result that torture (suitably defined) should be banned absolutely. It also yields prescriptions for the conduct of doctors where, in spite of them, torture is taking place.

Hare, R M

1993-01-01

323

Palliative sedation: not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation.  

PubMed

The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse the guideline's argumentation strategy with which euthanasia is demarcated from palliative sedation. First, we will analyse the guideline's main premise, which entails that palliative sedation is normal medical treatment. After this, we will critically discuss three crucial propositions of the guideline that are used to support this premise: (1) the patient's life expectancy should not exceed 2 weeks; (2) the aim of the physician should be to relieve suffering and (3) expert consultation is optional. We will conclude that, if inherent problematic aspects of palliative sedation are taken seriously, palliative sedation is less normal than it is now depicted in the guideline. PMID:22811556

Janssens, Rien; van Delden, Johannes J M; Widdershoven, Guy A M

2012-07-18

324

[Ethical and theoretical medical comments on the desire and reality of individualised medicine].  

PubMed

Starting from an epistemological position of individualized medicine this article deals with the ethical analysis of this complex topic. The need for evidence-based decisions-as opposed to interest-driven decisions-is emphasised. Based on the argument of social justifiability it can be first stated as an intermediate result that genome-based research, which aims to promote individualisation of medicine, does not exclude research that uses other diagnostic markers, and the appropriate ethical standards can be applied. Second, the development of individualised preventive medicine in the field of multifactorial diseases should increasingly study the potential cost savings of genetic risk diagnosis compared to the costs for the actual treatment options. For proper, medically reasonable, ethically justifiable and socially desired implementation of all areas of individualised medicine, clear separation between research and care as well as the simultaneous implementation of ethical, legal, methodological and technical standards is desirable; however these must be continuously developed in order to respond to possible boundary changes that may arise. Finally, the challenge remains to make the efficacy, operationalisation, performance, and affordability of individualised medicine plausible in the context of social justifiability. PMID:24170076

Paul, N W; Mitzkat, A

2013-11-01

325

Military Ethics: Reflections on Principles - the Profession of Arms, Military Leadership, Ethical Practices, War and Morality, Educating the Citizen-Soldier,  

National Technical Information Service (NTIS)

Contents: The Profession of Arms- -Professionals or Hired Guns. Loyalties are the Difference; A Code of Ethics for Officers; Military Leadership- -Machiavelli, Management, and Moral Leadership; Ethical Aspects of the Exercise of Command; Ethics and the Mi...

M. M. Wakin K. H. Wenker J. Kempf

1987-01-01

326

77 FR 73669 - Response to Comments Received for the “The Menlo Report: Ethical Principles Guiding Information...  

Federal Register 2010, 2011, 2012, 2013

...Security Division (CSD), Protected Repository for the Defense of Infrastructure Against...from ICTR 6. Applicability of the Institutional Review Board (IRB) model for ethical...in ICTR. E. Applicability of the Institutional Review Board (IRB) Model...

2012-12-11

327

A Model for Ethical Decision Making in Business: Reasoning, Intuition, and Rational Moral Principles  

Microsoft Academic Search

How do business leaders make ethical decisions? Given the significant and wide-spread impact of business people’s decisions\\u000a on multiple constituents (e.g., customers, employees, shareholders, competitors, and suppliers), how they make decisions matters.\\u000a Unethical decisions harm the decision makers themselves as well as others, whereas ethical decisions have the opposite effect.\\u000a Based on data from a study on strategic decision making

Jaana Woiceshyn

2011-01-01

328

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

PubMed Central

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.

Bryan, Charles S.

2003-01-01

329

The principles of writing the medical guide for ships.  

PubMed

The medical training and skills of seafarers are rather limited. In Finland, the master is responsible for medical care of his crew members, having only a 5-day training in medical matters which is refreshed every year. As medical incidents are rather rare events on board ship, he has not many opportunities to increase his knowledge in this field. Highly educated and experienced medical doctors have written medical guides for ships, describing diseases and advising on their treatment. This advice is based on diagnoses made on board ship by masters. They are often incorrect, therefore the advice on treatment may also be not correct. Authors of medical guides for ships should take into consideration the limited skills and medical knowledge of persons responsible for providing health services for crews at sea. This service is usually limited to giving first aid in accidents and sudden diseases, and care of the injured or sick seafarer until he can be transported to a medical facility on shore. Long lists of possible diagnoses in the text of such a guide only cause confusion in situations on board ship. In the new edition of the guide published in Finland in 2002, the advice on treatment is based on symptoms rather than on diagnoses. PMID:14974791

Saarni, Heikki

2003-01-01

330

Medical and ethical issues in genetic screening--an academic view.  

PubMed Central

This article is intended to acquaint those whose principal concerns are the health and safety of workers with genetic screening and some of the medical and ethical issues it raises. Population-based genetic screening increasingly is being considered for predicting future disease in the person being screened. A major problem in screening for alleles that contribute to the development of common, multifactorial disorders is low sensitivity and positive predictive value. In many instances, no demonstrably effective prophylaxis or treatment is available to help those with positive test results. This creates ethical problems of assuring that testing is in the person's best interest and raises in turn issues of autonomy, discrimination, and privacy. Instead of screening for genetic predispositions to harm from workplace exposures, other means of improving the health of workers may bring greater benefits to a higher proportion of workers. The current state of genetic tests for chronic beryllium disease are considered. None are suitable for screening.

Holtzman, N A

1996-01-01

331

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

PubMed

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

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

2012-11-24

332

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

PubMed

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

Barilan, Y M; Brusa, M

2013-02-01

333

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

PubMed

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

Brakewood, Beth; Poldrack, Russell A

2013-03-04

334

The Implementation of the Sharia Law in Medical Practice: A Balance between Medical Ethics and Patients Rights.  

PubMed

As medical ethics indisputably needs to consider patients' religious beliefs and spiritual ideas, one can suggest that hospitals are responsible for not only patients' rights and dignity, but also for her/his religious concerns and expectations. The current study is designed shed some light on the patients' view of the implementation of religious law in Iranian hospitals, specifically, the right of patients to be visited and delivered health services by professionals from the same sex. This protocol is proposed by the Ministry of Health and Medical Education of the Islamic Republic of Iran as a response to the increasing demand for implementation of the religious law by Iranian patients. This research is a cross-sectional study which was conducted at four teaching general hospitals in Tehran, Iran. The data was collected by the means of a questionnaire distributed to 120 women who were admitted to different wards of the hospitals. These women were asked to express their opinion of the implementation the Same Sex Health Care Delivery (SSHCD) system in Iranian hospitals. All analyses were performed with the use of SPSS software, version 16.0. The results indicate that half of the hospitalized women believed that being visited by a physician from the same gender is necessary who advocated the implementation of SSHCD in a clinical setting; and most of their husbands preferred their wives to be visited exclusively by female physicians. This study highlights the view of the Iranian patients towards the issue and urges the Ministry of Health and Medical Education of the Islamic Republic of Iran to accelerate the implementation of this law. SSHCD is what the majority of Iranian patients prefer, and, considering patients' rights and the medical ethics, it should be implemented by Iranian policy makers. PMID:23908749

Dargahi, Hossein

2011-07-27

335

The Implementation of the Sharia Law in Medical Practice: A Balance between Medical Ethics and Patients Rights  

PubMed Central

As medical ethics indisputably needs to consider patients’ religious beliefs and spiritual ideas, one can suggest that hospitals are responsible for not only patients’ rights and dignity, but also for her/his religious concerns and expectations. The current study is designed shed some light on the patients’ view of the implementation of religious law in Iranian hospitals, specifically, the right of patients to be visited and delivered health services by professionals from the same sex. This protocol is proposed by the Ministry of Health and Medical Education of the Islamic Republic of Iran as a response to the increasing demand for implementation of the religious law by Iranian patients. This research is a cross-sectional study which was conducted at four teaching general hospitals in Tehran, Iran. The data was collected by the means of a questionnaire distributed to 120 women who were admitted to different wards of the hospitals. These women were asked to express their opinion of the implementation the Same Sex Health Care Delivery (SSHCD) system in Iranian hospitals. All analyses were performed with the use of SPSS software, version 16.0. The results indicate that half of the hospitalized women believed that being visited by a physician from the same gender is necessary who advocated the implementation of SSHCD in a clinical setting; and most of their husbands preferred their wives to be visited exclusively by female physicians. This study highlights the view of the Iranian patients towards the issue and urges the Ministry of Health and Medical Education of the Islamic Republic of Iran to accelerate the implementation of this law. SSHCD is what the majority of Iranian patients prefer, and, considering patients’ rights and the medical ethics, it should be implemented by Iranian policy makers.

Dargahi, Hossein

2011-01-01

336

Focus on Teaching: Ethics.  

ERIC Educational Resources Information Center

Notes that business today is concerned with the translation and application of ethical principles into everyday business life. Offers a list of Web sites on ethics and business ethics at various colleges and universities. (SR)

Worley, Rebecca B.; Dyrud, Marilyn A.

1998-01-01

337

Focus on Teaching: Ethics.  

ERIC Educational Resources Information Center

|Notes that business today is concerned with the translation and application of ethical principles into everyday business life. Offers a list of Web sites on ethics and business ethics at various colleges and universities. (SR)|

Worley, Rebecca B.; Dyrud, Marilyn A.

1998-01-01

338

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

ERIC Educational Resources Information Center

|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…

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

2009-01-01

339

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

Microsoft Academic Search

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

Cynthia Forlini; Eric Racine

2009-01-01

340

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

PubMed

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

Maehle, Andreas-Holger

2012-04-01

341

Using faculty consensus to develop and implement a medical ethics course.  

PubMed

This report describes the development and implementation of a new required course in medical ethics for second-year medical students at the Cornell University Medical College, 1988-89 and 1989-90. The course was specifically designed to teach students who had not yet started their clinical clerkships to think critically and systematically about ethical issues faced by practicing physicians. The goals, structure, and content of the course were developed using an innovative technique, a planning model involving faculty consensus. The faculty members found the planning sessions intellectually challenging and enjoyable, and reported that the sessions added greatly to their teaching of the course. The students' evaluations over the first two years of the course (with 188 of the 201 students--94%--responding) documented the students' satisfaction with the content and the structure of the course, and their belief that the course had achieved its goals. The authors conclude that the faculty's participation in the planning process was crucial to the success of the course. PMID:1596340

Ales, K L; Charlson, M E; Williams-Russo, P; Allegrante, J P

1992-06-01

342

[The PEG-dilemma - pleading for an ethically responsible medical treatment].  

PubMed

Within the 32 years of its existence our attitude towards artificial enteral nutrition via PEG-tubes has changed in a fundamental way: in our modern understanding nutrition via PEG is supportive, early, preventive, and in many cases temporary. PEG-feeding is not an alternative but a possible supplement to normal oral food intake and requires an individual medical indication as well as an ethical justification. This does not follow standardised algorithmic thinking but is decided on an individual base taking personal wishes, resources, and needs of the individual patient into account. Nutrition via PEG-tube is not a terminal basic or even symbolic treatment at the end of life. The present dilemma of the PEG is that the public discussion primarily focus one-sided on the problems of PEG-placement in multimorbid, elderly, and/or demented patients or patients in end-stage tumour diseases where indeed PEG-placement is neither medically nor ethically justified - we still place PEG-tubes to often in the wrong patients! On the other hand we still consider supportive and in many cases temporary nutrition via PEG too rare and even too late in those patients which clearly could benefit from an early, supportive, and preventive PEG-treatment on the base of our present evidence-based scientific knowledge - we still consider PEG-treatment not adequately and in most cases too late in the right patients! Placing a PEG-tube is not the second last step before death and physicians have to accept the ethically given limits of medical treatment by realizing our modern understanding of the benefits and limits of supportive artificial nutrition via PEG. PMID:23681898

Löser, Chr

2013-05-16

343

A patient with autism and severe depression: medical and ethical challenges for an adolescent medicine unit.  

PubMed

An adolescent with autism and intellectual disability presented with severe depression related to menstruation. Because of the complex medical, psychiatric and ethical issues involved, her care was coordinated by a hospital-based adolescent medicine unit. After trials of other therapies over an extended period and interdisciplinary and intersectoral case conferencing, it was decided that hysterectomy was the most appropriate management. This case highlights the complexity of adolescent health care in a tertiary hospital, the importance of intersectoral cooperation between hospital and community, and the integral role of interdisciplinary care of adolescent patients with chronic conditions. PMID:16225449

Skinner, S Rachel; Ng, Cindy; McDonald, Ann; Walters, Tamara

2005-10-17

344

A code of professional ethical conduct for the American Medical Informatics Association: an AMIA Board of Directors approved white paper.  

PubMed

The AMIA Board of Directors has decided to periodically publish AMIA's Code of Professional Ethical Conduct for its members in the Journal of the American Medical Informatics Association. The Code also will be available on the AMIA Web site at www.amia.org as it continues to evolve in response to feedback from the AMIA membership. The AMIA Board acknowledges the continuing work and dedication of the AMIA Ethics Committee. AMIA is the copyright holder of this work. PMID:17460125

Hurdle, John F; Adams, Samantha; Brokel, Jane; Chang, Betty; Embi, Peter; Petersen, Carolyn; Terrazas, Enrique; Winkelstein, Peter

2007-04-25

345

Ethical Dilemmas in Disaster Medicine  

PubMed Central

Background Disasters may lead to ethical challenges that are different from usual medical practices. In addition, disaster situations are related with public health ethics more than medical ethics, and accordingly may require stronger effort to achieve a balance between individual and collective rights. This paper aims to review some ethical dilemmas that arise in disasters and mainly focuses on health services. Disasters vary considerably with respect to their time, place and extent; therefore, ethical questions may not always have `one-size-fits-all` answers. On the other hand, embedding ethical values and principles in every aspect of health-care is of vital importance. Reviewing legal and organizational regulations, developing health-care related guidelines, and disaster recovery plans, establishing on-call ethics committees as well as adequate in-service training of health-care workers for ethical competence are among the most critical steps. It is only by making efforts before disasters, that ethical challenges can be minimized in disaster responses.

Ozge Karadag, C; Kerim Hakan, A

2012-01-01

346

More medical journals should inform their contributors about three key principles of graph construction  

Microsoft Academic Search

Objectives: To identify key principles of graph construction and to review guidance on graph construction provided by medical journals. Study Design and Setting: Review of a prevailing model of graph comprehension and survey of authors' instructions for all 120 core medical journals as indexed by PubMed. Results: Graph construction should meet three requirements for optimal graph comprehension: Data symbols should

Milo A. Puhan; Gerben ter Riet; Klaus Eichler; Johann Steurer; Lucas M. Bachmann

2006-01-01

347

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

ERIC Educational Resources Information Center

|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…

Pettifor, Jean L.

2004-01-01

348

Improving American Police Ethics Training: Focusing on Social Contract Theory and Constitutional Principles  

Microsoft Academic Search

Americans have good reason to fear the awesome power granted to police officers and to demand that these government officials adhere to the strictest of ethical standards in carrying out their duties. No other government official has such direct power and immediate access to regularly deprive the average citizen of their liberties. Other scholars (Cohen and Feldberg, 1991; Fitzpatrick, 2006)

Monica M. Moll

349

The Relation between the Ethics of Personal Conscience-Social Responsibility and Principled Moral Reasoning.  

ERIC Educational Resources Information Center

|College students were tested on Hogan's Survey of Ethical Attitudes, Rest's Defining Issues Test, Collins' revision of Rotter's Internal-External Scale, and Snyder's Self-Monitoring Scale. Subjects who endorsed personal conscience showed greater maturity in moral reasoning. The subjects who advocated social responsibility tended to show more…

Gutkin, Daniel C.; Suls, Jerry

1979-01-01

350

ETHICS IN ACCOUNTING EDUCATION: CONTRIBUTION OF THE ISLAMIC PRINCIPLE OF MASLAHAH  

Microsoft Academic Search

There is a growing concern over the apparently low moral standards of some accountants and an increasing number of academics who suggest that the education system should bear some of the blame. Ethical components in accounting education have been found to be insufficient and there is a lack of emphasis on humanizing accountants. The objective of this paper is firstly

Abdul Rahim Abdul Rahman

2003-01-01

351

A Trustworthy Computing of ADAPT Principle Guaranteeing Genuine Medical Image  

Microsoft Academic Search

Cancer is usually treated with surgery and probably with chemotherapy or radiation. A medical malpractice of breast cancer has become an urgent need to clear the mess based on technical, workable strategy. The paper tries to: (i) understand a general diagnosis, (ii) pay attentions on how to improve the right judgments of possible misinterpretation, (iii) focus on breast cancer malpractice

Da-Yu Kao; Shiuh-Jeng Wang; Dushyant Goyal; Jonathan Liu

2011-01-01

352

[Perioperative care of palliative patients by the anesthetist : medical, psychosocial and ethical challenges].  

PubMed

Anesthetists will encounter palliative patients in the daily routine as palliative patients undergo operations and interventions as well, depending on the state of the disease. The first challenge for anesthetists will be to recognize the patient as being palliative. In the course of further treatment it will be necessary to address the specific problems of this patient group. Medical problems are optimized symptom control and the patient's pre-existing medication. In the psychosocial domain, good communication skills are expected of anesthetists, especially during the preoperative interview. Ethical conflicts exist with the decision-making process for surgery and the handling of perioperative do-not-resuscitate orders. This article addresses these areas of conflict and the aim is to enable anesthetists to provide the best possible perioperative care to this vulnerable patient group with the goal to maintain quality of life and keep postoperative recovery as short as possible. PMID:23836144

Lassen, C L; Abel, R; Eichler, L; Zausig, Y A; Graf, B M; Wiese, C H R

2013-08-01

353

Too Strong for Principle: An Examination of the Theory and Philosophical Implications of Evolutionary Ethics  

Microsoft Academic Search

Evolutionary ethics is a discipline that has formed around the belief that human-kind’s conception of morality was developed through the evolutionary process of natural selection. Various mechanisms concern-ing the evolution of morality have been proposed within the theory of natural selection, and I believe that many authors in the field focus too narrowly on one or a few of them

Sam Rayner

2006-01-01

354

The Principled Legal Firm: Insights into the Professional Ideals and Ethical Values of Partners and Lawyers  

Microsoft Academic Search

Understanding how the professional ideals and values of partners influence lawyers’ everyday life is a relatively unexplored\\u000a area given the inherent difficulties of gaining access to lawyers. This case study sheds light on the professional ideals\\u000a and ethical values of partners and lawyers in a mid-tier Sydney law firm. Semi-structured interviews with partners and lawyers\\/legal\\u000a clerks reveal how partners’ professional

Richard Winter

2011-01-01

355

The relation between the ethics of personal conscience—social responsibility and principled moral reasoning  

Microsoft Academic Search

Three samples of college students were tested on Hogan's Survey of Ethical Attitudes (SEA) and Rest's Defining Issues Test (DIT), a test of moral reasoning ability in the Kohlbergian tradition. In addition, one of the samples took Collins's revision of Rotter's Internal-External Scale (I-E) while another sample took Snyder's Self-Monitoring Scale. There was a small but reliable tendency for subjects

Daniel C. Gutkin; Jerry Suls

1979-01-01

356

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 Central

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.

Tobin, J

2005-01-01

357

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

PubMed

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

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

2012-01-01

358

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

PubMed Central

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.

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

2009-01-01

359

Informed consent and neuropsychological assessment: Ethical considerations and proposed guidelines  

Microsoft Academic Search

The rationale for obtaining informed consent from patients contains a number of legal, ethical, and moral arguments that are well entrenched in the medical community but which have been embraced only recently by psychologists. The current Ethical Principles of Psychologists and Code of Conduct (1992) elucidate informed consent guidelines for treatment and research, but do not provide the same degree

Doug Johnson-greene; Corinne Hardy-morais; Kenneth M. Adams; Christine Hardy; Paula Bergloff

1997-01-01

360

The prevention of hemorrhagic stroke. A review of the rational and ethical principles of clinical trials on unruptured intracranial aneurysms and arteriovenous malformations.  

PubMed

Summary: There is currently no evidence that preventive treatment of unruptured aneurysms or AVMs is beneficial and randomized trials have been proposed to address this clinical uncertainty. Participation in a trial may necessitate a shift of point of view compared to a certain habitual clinical mentality. A review of the ethical and rational principles governing the design and realization of a trial may help integrate clinical research into expert clinical practices. The treatment of unruptured aneurysms and AVMs remains controversial, and data from observational studies cannot provide a normative basis for clinical decisions. Prevention targets healthy individuals and hence has an obligation of results. There is no opposition between the search for objective facts using scientific methods and the ethics of medical practice since a good practice cannot forbid physicians the means to define what could be beneficial to patients. Perhaps the most difficult task is to recognize the uncertainty that is crucial to allow resorting to trial methodology. The reasoning that is used in research and analysis differs from the casuistic methods typical of clinical work, but clinical judgement remains the dominant factor that decides both who enters the trial and to whom the results of the trial will apply. Randomization is still perceived as a difficult and strange method to integrate into normal practice, but in the face of uncertainty it assures the best chances for the best outcome to each participant. Some tension exists between scientific methods and normal practice, but they need to coexist if we are to progress at the same time we care for patients. PMID:20557736

Raymond, J; Mohr, J P

2009-01-05

361

[Ethical and legal principles for the activities of bioprospection in relation to human beings and the human genome].  

PubMed

During recent decades, bioprospecting has become an important field of research, which looks for development alternatives, entry into global (environmental) markets, and the subsequent obtention of benefits under sustainable development principles. However, there is still so much to discuss regarding the social and environmental impacts produced by this activity, as well as its main limitations. To this end, the Forum/round-table discussion, entitled "Bioprospección, Etica y Sociedad" was organised to take place on 28 March 2012 at the National University of Colombia. Its main objective was to enrich our knowledge on bioprospecting considering the ethical considerations that involve society. The presentation given by Professor ROMEO CASABONA, regarding the connection between bioprospecting and the human genome deserves special attention and is presented below. PMID:23115822

Romeo Casabona, Carlos María

362

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

|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…

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

2011-01-01

363

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

PubMed Central

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.

Wall, L L

2006-01-01

364

Ethical and social issues in the care of the newborn  

Microsoft Academic Search

Ethical and social issues are based upon a system of moral values that serve the best interests of the society in a humane\\u000a and compassionate manner. The ethical decisions should be based upon the well-enunciated principles of beneficence, non-maleficence,\\u000a parental autonomy, correct medical facts and justice. In view of our economic constraints, we should follow the philosophy\\u000a of utilatarian ethics

Meharban Singh

2003-01-01

365

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

Microsoft Academic Search

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

Ruud H. J. ter Meulen; Ruud H. J. ter

2005-01-01

366

Ethical issues for cancer screening.  

PubMed

In recent years medical ethics has become an undisputed part of medical studies. Many people believe that modern advances in medical technology - such as the development of dialysis machines, respirators, magnetic resonance imaging and genetic testing and types of cancer screenings - have created bioethical dilemmas that confront physicians in the 21st century. Debates over research and screening ethics have until recently revolved around two related questions: the voluntary, informed consent of subjects, and the appropriate relationship between risk and benefit to subjects. Every patient has a right to full and accurate information about his or her medical condition. This legal principle arose primarily through court decisions concerning informed consent, but over time physicians recognized that most patients prefer to learn the truth about their condition and use the information well. To screen is to search for disease in the absence of symptoms or, in other words, to attempt to find disease in someone not thought to have a disease. Examples of screening include routine mammography to detect breast cancer, routine pap smears to detect cervical cancer, and routine Prostate Specific Antigen (PSA) testing to detect prostate cancer. Ethical principles to be followed in cancer screening programmes are intended mainly to minimize unnecessary harm for the participating individuals. Numerous ethical questions can be raised about the practice of screening for disease. Here, we examine four leading cancer killers worldwide and we review the screening of protocols of these cancer types and their possible ethics. PMID:14728598

Ustun, Cagatay; Ceber, Esin

367

A Data-Generated Basis for Medical Ethics Education: Categorizing Issues Experienced by Students during Clinical Training.  

ERIC Educational Resources Information Center

A survey of 249 students at the State University of New York at Buffalo identified medical ethics issues arising during clinical training in professional norms, limits of intervention, defensive shielding of professional colleagues, respect toward patients, communication, and student boundaries. Concerns differed by student year, supporting…

Bissonette, Raymond; And Others

1995-01-01

368

Prenatal Dexamethasone for Congenital Adrenal Hyperplasia: An Ethics Canary in the Modern Medical Mine.  

PubMed

Following extensive examination of published and unpublished materials, we provide a history of the use of dexamethasone in pregnant women at risk of carrying a female fetus affected by congenital adrenal hyperplasia (CAH). This intervention has been aimed at preventing development of ambiguous genitalia, the urogenital sinus, tomboyism, and lesbianism. We map out ethical problems in this history, including: misleading promotion to physicians and CAH-affected families; de facto experimentation without the necessary protections of approved research; troubling parallels to the history of prenatal use of diethylstilbestrol (DES); and the use of medicine and public monies to attempt prevention of benign behavioral sex variations. Critical attention is directed at recent investigations by the U.S. Food and Drug Administration (FDA) and Office of Human Research Protections (OHRP); we argue that the weak and unsupported conclusions of these investigations indicate major gaps in the systems meant to protect subjects of high-risk medical research. PMID:22904609

Dreger, Alice; Feder, Ellen K; Tamar-Mattis, Anne

2012-07-31

369

Relay kidney transplantation in Korea--legal, ethical and medical aspects.  

PubMed

Living kidney transplantations constitute the majority of kidney transplantations in Korea. Recently, relay kidney transplantation, which is a modified form of both 'exchange transplantation' and 'living anonymous donation', has become at issue. After a living anonymous donor makes the initial donation, the next donor, who is related to the first recipient, makes the second donation; the third donor, who is related to the second recipient, makes the third donation; and so on. In relay kidney transplantation, organ trafficking, coercion of donation, assessment order, breach of agreement, and recipient burden should be evaluated with respect to ethical, legal and medical considerations. Despite these problems, a non-governmental body, the Korean Organ and Tissue Donor Program, has been promoting relay kidney transplantations to address the shortage of cadaveric kidney donations. Acceptance of the method of relay kidney transplantation requires the institution of supplementary measures to minimize the related problems. PMID:15231288

Park, Jong-Hyun; Park, Joong-Won; Koo, Young-Mo; Kim, Jang Han

2004-07-01

370

A national survey concerning the ethical aspects of informed consent and role of medical students.  

PubMed

The authors surveyed a national random sample of medical students (10 percent of the graduating class of 1985) to identify the ways in which the students obtained informed consent from their patients and to learn the students' views of certain issues concerning informed consent. The results showed that the students introduced themselves to patients using methods that the authors grouped by levels of forthrightness. Those students who introduced themselves as medical students differed in their views on selected informed consent issues from students who introduced themselves as physicians. In general, all the students were less forthright about their status when given the opportunity to perform invasive procedures. Student gender, type of patient, and type of hospital were statistically associated with the students' behavior, according to bivariate analysis. After multivariate regression analysis, however, only the actions of the students' role models (residents and attending physicians) remained significantly associated with the students' behavior. The authors conclude that because some aspects of student behavior are at odds with the requirements of informed consent, medical educators must scrutinize the ethical dimensions of the policies they establish. PMID:3184147

Cohen, D L; McCullough, L B; Kessel, R W; Apostolides, A Y; Heiderich, K J; Alden, E R

1988-11-01

371

Ethical issues related to professional exposure of pregnant women in the medical field: monitoring and limiting effective dose.  

PubMed

The International Commission on Radiological Protection recommendations for occupational exposed pregnant women do not imply necessarily the complete avoidance of work with radiation or radioactive materials. Instead, a careful review of the exposure conditions, once the pregnancy is declared, as part of the exercise of the ICRP optimisation principle (based in a teleological ethics point of view) is suggested. The dose limitation (following a deontological ethics point of view) of the fetus/embryo is, however, not clearly well established as happens in the case of workers or members of the public. Also, the justification of practices (to continue to work or not with radiation or radioactive materials) is not clearly addressed in most national or international recommendations. An analysis of this justification (bearing in mind both teleological and deontological ethics) is examined in this work having in mind the best interest of the child-to-be as well as other existing social and economical factors. PMID:21068015

Santos, J A M; Nunes, R

2010-11-09

372

Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions.  

PubMed

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. Difficult decisions about who will and will not receive these scarce resources will have to be made. 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 on the basis 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 patients who have had the least chance to live through life's stages. We also argue that these principles are relevant to all patients and therefore should be applied to all patients, rather than selectively to the elderly, those with functional impairment, and those with certain chronic conditions. We discuss strategies to engage the public in setting the priorities that will guide allocation of scarce life-sustaining treatments during a public health emergency. PMID:19153413

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

2009-01-20

373

The ethics of managed care: challenges to the principles of relationship-centered care.  

PubMed

Health care reform involves ethical issues on many levels. First, the impetus to reform the health care system stems in large part from concerns about equity, just distribution of goods and services, and commitments to one another in society. Health care itself is more than a commodity, it is a personal healing activity carried out through institutions that embody values such as respect for persons, the value of human life, and duties to care for individuals who suffer. These issues fall under major overarching concerns on the macro level. Reform, however, often functions as a euphemism for changing the health care system to provide greater profitability, and for controlling costs. Admittedly, such changes can be disguised under reforming the health care system, and indeed, some of them are capable of enhancing and simultaneously making more efficient, our care for one another when sick. Most changes, nonetheless, are clearly driven from less noble ideals. Every schema for providing care also embodies values since these schemas presuppose various competing notions of justice and equity. Further, they may endanger long-held values of health care providers in meeting the needs of patients. As part of state or local-level changes in the health care system, issues in this category can be called micro level concerns. when all the changes impact on individuals, either providers of care, or the patients themselves, then the issues are of concern on the personal level. This essay, therefore, examines ethical issues presented by managed care networks on the macro, micro, and individual level, with special attention paid to the health care relationship. The subtitle of the essay points out the focus of the discussion on the impact of these changes for more traditional models of relationship-centered care.1 In particular, the essay concentrates on health providers, including allied health professionals, that in the past were grouped into the category of primary care givers but ought to be called first-level care givers today. PMID:8884435

Thomasma, D C

1996-01-01

374

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

PubMed

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

Azétsop, Jacquineau; Rennie, Stuart

2010-01-18

375

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

PubMed Central

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.

2010-01-01

376

Informal medicine: ethical analysis  

PubMed Central

Context: Doctors have been known to treat or give consultation to patients informally, with none of the usual record keeping or follow up. They may wish to know whether this practice is ethical. Objective: To determine whether this practice meets criteria of medical ethics. Design: Informal medicine is analysed according to standard ethical principles: autonomy, beneficence and non-maleficence, distributive and procedural justice, and caring. Setting: Hospital, medical school, and other settings where patients may turn to physicians for informal help. Conclusion: No generalisation can be made to the effect that informal medicine is or is not ethical. Each request for informal consultation must be considered on its own merits. Guidelines: Informal medicine may be ethical if no payment is involved, and when the patient is fully aware of the benefits and risks of a lack of record keeping. When an informal consultation does not entail any danger to the patient or others, the physician may agree to the request. If, however, any danger to the patient or others is foreseen, then the physician must insist on professional autonomy, and consider refusing the request and persuading the patient to accept formal consultation. If a reportable infectious disease, or other serious danger to the community, is involved, the physician should refuse informal consultation or treatment, or at least make a proper report even if the consultation was informal. If agreeing to the request will result in an unfair drain on the physician's time or energy, he or she should refuse politely.

Leavitt, F; Peleg, R; Peleg, A

2005-01-01

377

Medical and genetic differences in the adverse impact of sleep loss on performance: ethical considerations for the medical profession.  

PubMed

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

Czeisler, Charles A

2009-01-01

378

The philosophical background: from principles to rules and analysis.  

PubMed

Encounters between doctors and patients are subtle but complex forms of social interaction. Attempts to regulate aspects of the doctor-patient relationship have a long history. Initially, the production of guidance on principles and conduct was the domain of practitioners. In the 21st century, modern medical ethics still reflects some of this traditional thinking even though the responsibility for formulating ethical guidance increasingly falls to policy-makers, lawyers and theoreticians rather than doctors. Ethical concepts are also increasingly interwoven with contemporaneous concepts of patient autonomy, human rights and law. In a brief and necessarily sketchy overview of some of the key influences on European ethical development, this article traces the development of medical ethics through three broad stages: from principles to rules to providing tools for detailed moral analysis. It also discusses whether the original Hippocratic principles still find echo with modern doctors. PMID:12566601

Sommerville, Ann

2002-01-01

379

Does a Sentiment-Based Ethics of Caring Improve upon a Principles-Based One? The Problem of Impartial Morality  

ERIC Educational Resources Information Center

My task in this paper is to demonstrate, contra Nel Noddings, that Kantian ethics does not have an expectation of treating those closest to one the same as one would a stranger. In fact, Kantian ethics has what I would consider a robust statement of how it is that those around us come to figure prominently in the development of one's ethics. To…

Johnston, James Scott

2008-01-01

380

[Civil responsibility of medical care activities in regard to the precautionary principle].  

PubMed

In the absence of a legal body regulating the precaution, do we have to confine the principle to public health? A negative answer is required at a time the medical liability is increasing more and more and the obligation to take all means is slipping toward to a strict obligation as to the result. The respect of the principle of precaution can be found in the obligation for the doctor to prove that he has fully informed the patient, but the medicine specificity requires delimitation of this obligation outlines. PMID:11077712

Le Foyer de Costil, H

2000-01-01

381

Using Legal and Ethical Principles to Guide Clinical Decision Making in Complementary\\/Integrative Cancer Medicine  

Microsoft Academic Search

The integration of complementary and alternative medical (CAM) therapies into cancer medicine raises legal issues for clinicians\\u000a who may be initiating delivery of CAM therapies, referring patients to CAM providers, or simply responding to patient requests\\u000a concerning specific CAM modalities. This chapter addresses some of the key legal issues and liability risk management strategies\\u000a legal issues and liability risk management

Michael H. Cohen

382

Ethical issues in medical research in the developing world: a report on a meeting organised by Fondation Mérieux.  

PubMed

This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future. Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged. PMID:18312433

Perrey, Christophe; Wassenaar, Douglas; Gilchrist, Shawn; Ivanoff, Bernard

2008-02-27

383

The task of nursing ethics  

Microsoft Academic Search

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

K M Melia

1994-01-01

384

Narrowing the gap between rhetoric and the reality of medical ethics.  

PubMed

A major challenge for academic medical education is to sensibly balance the needs of students and residents for hands-on training with the rights of patients to receive the highest quality of care. Two aspects of the debate over this issue have received a great deal of attention: the appropriate degree of patient control over the makeup of the treatment team, and the proper role of supervision and accountability for attending physicians. Although the law has ostensibly resolved the conflict between the goals of student participation and the principles of patient autonomy and informed consent, the record of medical practices is too often inapposite. The divergence of law and reality is primarily a reflection of the law's flawed medical model, which poorly matches the dynamics of the physician-patient relationship and ineffectually attempts to reshape it. But the dissonance is also attributable to medicine's autonomous professional culture, which undervalues patient involvement and reinforces benign paternalism. Coherent policy requires a recrystallization of both the legal ideal and the medical reality. Lawyers and ethicists should loosen their rigid consumerist conception of medicine, and physicians should become more conscious of the infiltration of paternalism and instrumentalism into their decisions. PMID:8607917

Silverman, D R

1996-03-01

385

The use of Food and Drug Administration--approved medications for unlabeled (off-label) uses. The legal and ethical implications.  

PubMed

Physicians increasingly use Food and Drug Administration (FDA)-approved drugs (medication) for unlabeled (off-label) indications. The ethical and legal implications of these actions are not always clear. In this article, I examine the common law and federal statutory regulations concerning this issue and also explore some of the ethical and financial issues involved. PMID:8285737

Torres, A

1994-01-01

386

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

PubMed

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

Huddle, Thomas S

2010-01-01

387

Evoking the moral imagination: using stories to teach ethics and professionalism to nursing, medical, and law students.  

PubMed

Four years ago, as colleagues in our university's law and medical schools, we designed and began offering a course for law, medical, and nursing students, studying professionalism and professional ethics by reading and discussing current and earlier images of nurses, doctors, and lawyers in literature. We wanted to make professional ethics, professional culture, and professional education the objects of study rather than simply the unreflective consequences of exposure to professional language, culture, and training. We wanted to do it in an interdisciplinary course where aspiring professionals could share their self-conceptions and their conceptions of each other, and we wanted to do it by using stories, our primary means for organizing experience and claiming meaning for it. This article tells the story of that experience: why we did it; how we did it; what we learned from doing it. PMID:11654208

Weisberg, Mark; Duffin, Jacalyn

1995-01-01

388

Ethics in Clinical Research: The Indian Perspective  

PubMed Central

Ethics in clinical research focuses largely on identifying and implementing the acceptable conditions for exposure of some individuals to risks and burdens for the benefit of society at large. Ethical guidelines for clinical research were formulated only after discovery of inhumane behaviour with participants during research experiments. The Nuremberg Code was the first international code laying ethical principles for clinical research. With increasing research all over, World Health Organization formulated guidelines in the form of Declaration of Helsinki in 1964. The US laid down its guidelines for ethical principles in the Belmont Report after discovery of the Tuskegee's Syphilis study. The Indian Council of Medical Research has laid down the ‘Ethical Guidelines for Biomedical Research on Human Subjects’ in the year 2000 which were revised in 2006. It gives twelve general principles to be followed by all biomedical researchers working in the country. The Ethics Committee stands as the bridge between the researcher and the ethical guidelines of the country. The basic responsibility of the Ethics Committee is to ensure an independent, competent and timely review of all ethical aspects of the project proposals received in order to safeguard the dignity, rights, safety and well-being of all actual or potential research participants. A well-documented informed consent process is the hallmark of any ethical research work. Informed consent respects individual's autonomy, to participate or not to participate in research. Concepts of vulnerable populations, therapeutic misconception and post trial access hold special importance in ethical conduct of research, especially in developing countries like India, where most of the research participants are uneducated and economically backward.

Sanmukhani, J.; Tripathi, C. B.

2011-01-01

389

Ethics in clinical research: the Indian perspective.  

PubMed

Ethics in clinical research focuses largely on identifying and implementing the acceptable conditions for exposure of some individuals to risks and burdens for the benefit of society at large. Ethical guidelines for clinical research were formulated only after discovery of inhumane behaviour with participants during research experiments. The Nuremberg Code was the first international code laying ethical principles for clinical research. With increasing research all over, World Health Organization formulated guidelines in the form of Declaration of Helsinki in 1964. The US laid down its guidelines for ethical principles in the Belmont Report after discovery of the Tuskegee's Syphilis study. The Indian Council of Medical Research has laid down the 'Ethical Guidelines for Biomedical Research on Human Subjects' in the year 2000 which were revised in 2006. It gives twelve general principles to be followed by all biomedical researchers working in the country. The Ethics Committee stands as the bridge between the researcher and the ethical guidelines of the country. The basic responsibility of the Ethics Committee is to ensure an independent, competent and timely review of all ethical aspects of the project proposals received in order to safeguard the dignity, rights, safety and well-being of all actual or potential research participants. A well-documented informed consent process is the hallmark of any ethical research work. Informed consent respects individual's autonomy, to participate or not to participate in research. Concepts of vulnerable populations, therapeutic misconception and post trial access hold special importance in ethical conduct of research, especially in developing countries like India, where most of the research participants are uneducated and economically backward. PMID:22303053

Sanmukhani, J; Tripathi, C B

2011-03-01

390

The practice setting: site of ethical conflict for some mothers and midwives.  

PubMed

Practitioners' ethical orientation and responses vary between practice settings. Yet, currently, the ethics for midwifery practice that is explicit in the literature and which provides the ideals of socialization into practice, is that of bio(medical)ethics. Traditional bioethics, developed because of World War II atrocities and increased scientific research, is based on moral philosophy, normative theory, abstract universal principles and objective problem solving, all of which focus on right and wrong 'action' for resolving dilemmas. They exclude context and relationship. Personal narratives of mothers and midwives contest the appropriateness of these accepted values and systems for childbirth because they induce conflict between workplace/service provider ethics and personal/professional midwifery ethics. In contrast to the disembedded and disembodied approach of biomedical ethics, an ethically adequate response in midwifery practice resonates more with the ethics of intimates, such as feminist virtue ethics. PMID:14650478

Thompson, Faye E

2003-11-01

391

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

Microsoft Academic Search

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

Beth Simmons

1978-01-01

392

Poland: biomedical ethics in a socialist state.  

PubMed

In one of a Hastings Center Report series of four country reports, a professor of ethics discusses the Polish approach to ethical issues in health care. Szawarski begins by outlining five factors that influence the practice of medicine in Poland: a socialist form of government, the influence of the Roman Catholic Church, an ongoing economic crisis, the legacy of the Nazi death camps, and a lack of formal instruction in biomedical ethics. He then discusses three current ethical concerns of physicians, patients, and the public: regulation of physician conduct, abortion, and in vitro fertilization. There is little formal public debate of the issues, however, and physicians seem committed to upholding traditional medical codes of ethics without analyzing underlying moral principles and justifications. PMID:11644027

Szawarski, Zbigniew

1987-06-01

393

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

PubMed Central

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.

Forlini, Cynthia; Racine, Eric

2009-01-01

394

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

PubMed Central

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.

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

2010-01-01

395

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

PubMed Central

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.

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

1997-01-01

396

Physicians’ and nurses’ perceptions of ethics problems on general medical services  

Microsoft Academic Search

Objective:To understand the kinds of clinical situations physicians and nurses regard as “ethics problems.”\\u000a \\u000a \\u000a Design:The authors prospectively studied physicians’ and nurses’ perceptions of ethics problems using paired interviews. Individual\\u000a interviews were conducted with physicians and nurses as they cared for the same patients during a six-week period. Each was\\u000a asked whether any ethics problems had arisen in the care of

Robert M. Walker; Steven H. Miles; Carol B. Stocking; Mark Siegler

1991-01-01

397

Defining Death: A Report on the Medical, Legal and Ethical Issues in the Determination of Death.  

National Technical Information Service (NTIS)

The enabling legislation for the President's Commission directs it to study the ethical and legal implications of the matter of defining death, including the advisability of developing a uniform definition of death. In performing its mandate, the Commissi...

1981-01-01

398

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

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

Arnold, Denis G; Oakley, James L

2013-02-15

399

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

PubMed Central

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.

Redelmeier, Donald A.; Cialdini, Robert B.

2002-01-01

400

Ethical aspects of obstetric care: expectations and experiences of patients in South East Nigeria  

PubMed Central

Background Medical ethics is not given due priority in obstetric care in many developing countries, and the extent to which patients value compliance with ethical precepts is largely unexplored. Objective To describe the expectations and experiences of obstetric patients in South East Nigeria with respect to how medical ethics principles were adhered to during their care. Methods This was a cross-sectional, questionnaire-based study involving parturient women followed in three tertiary hospitals in South East Nigeria. Results A total of 1,112 women were studied. The mean age of respondents was 29.7 ± 4.1 years. Approximately 98% had at least secondary education. Ninety-six percent considered ethical aspects of care as important. On the average, over 75% of patients expected their doctors to comply with the different principles of medical ethics and specifically, more than 76% of respondents expected their doctors to comply with ethical principles related to information and consent during their antenatal and delivery care. There was a statistically significant difference between the proportions of women who expected compliance of doctors with ethical principles and those who did not (P < 0.001). Multivariate analysis showed that increasing levels of skilled occupation (odds ratio [OR] 9.35, P < 0.001), and residence in urban areas (OR 2.41, P < 0.001) increased the likelihood of patients expecting to be informed about their medical conditions and their opinions being sought. Although the self-reported experiences of patients concerning adherence to ethical principles by doctors were encouraging, experiences fell short of expectations, as the level of expectation of patients was significantly higher than the level of observed compliance for all the principles of medical ethics. Conclusion The level of practice of medical ethics principles by doctors during obstetric care in South East Nigeria was encouraging but still fell short of the expectations of patients. It is recommended that curriculum-based training of doctors and medical students should be implemented, and hospital policy makers should do more to promote ethical aspects of care, by providing official written guidelines for adherence to medical ethical principles during obstetric care.

Iyoke, Chukwuemeka A; Ezugwu, Frank O; Ugwu, George O; Lawani, Osaheni L; Onyebuchi, Azubuike K

2013-01-01

401

Legal and ethical considerations in the treatment of psychosis.  

PubMed

A variety of legal and ethical issues surround any decision about the treatment of patients with psychosis. These issues have come to the forefront with the introduction of the atypical antipsychotic agents. The law defines the minimum expected level of conduct for a health care professional, and where the law ends, ethics begin. Adverse drug reactions are a leading cause of death in the United States, and medication error is a common reason for liability claims against health care professionals. Patients alleging negligence must prove that the health care professional owed a duty to the patient, that the duty was breached, that the patient was injured, and that the breach of duty was the legal cause of the injury. Professional ethics are governed by various models for ethical decision making. The principles model, which can be readily applied to the patient with mental illness, is based on the ethical principles of beneficence, nonmaleficence, autonomy, utility, and justice. PMID:10507282

Fitzgerald, W L

1999-01-01

402

Ethical issues in the application of medical technology to paediatric intensive care: two views of the newborn.  

PubMed

Recent advances in medical technology have led to a marked improvement in the chances of survival of sick or preterm infants, thereby stimulating renewed ethical debate on the status of the newborn. Two contradictory attitudes to the medical care of preterm or congenitally malformed newborn infants can be discerned in our pluralistic society. The two attitudes have their historical roots in the classical Graeco-Roman and Judaeo-Christian ethical traditions respectively. The former views newborn infants as of potential value only whereas the latter emphasises the intrinsic worth and dignity of the individual made in God's image. Recent secular philosophical reflection has provided a rationale for infanticide of the sick or abnormal newborn. A Christian approach to the care of the newborn prohibits intentional killing yet may encompass the withdrawal of treatment that is inappropriate or unduly burdensome. Medical care should be based upon respect for the value of the individual, protection of the defenceless from abuse or exploitation, and wise stewardship of limited health-care resources. PMID:15991428

Wyatt, J S

1996-04-01

403

"Love your neighbor like yourself": a Jewish ethical approach to the use of pain medication with potentially dangerous side effects.  

PubMed

Palliation of pain is universally regarded as a cardinal aspect of end-of-life care. In the early days of the palliative care and hospice movement there was concern that aggressive pain control with opioids could potentially hasten the death of the patient primarily through respiratory depression. For many ethicists and theologians who were opposed to active euthanasia, this raised the difficult question of whether it is permissible to use these potentially harmful medications. Traditional Jewish decisors also addressed this question and their writings can shed light on their attitudes toward terminal care. The purpose of this article is to analyze the view of three highly respected authorities on the use of pain medications with potentially significant side effects in terminal patients. The Jewish position demonstrates how an ancient tradition struggles to develop an ethic consistent with modern sensibilities. Religious decisors scour the ancient sources to find precedents and then apply that wisdom to contemporary questions. Jewish medical ethics by its very nature is highly pluralistic because there is no central body that determines policy and a wide spectrum of opinions are usually found. However, regarding pain treatment there appears to be a broad consensus mandating its aggressive use even at the risk of significant side effects as long as the motivation is relief of suffering. PMID:19827965

Jotkowitz, Alan; Zivotofsky, Ari Z

2010-01-01

404

Pharmacy ethics: evaluation pharmacists' ethical attitude.  

PubMed

Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making. Pharmacists' knowledge as well as ethical reasoning affects their clinical decision-making. Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance. The study was designed to evaluate pharmacists' attitude toward some principles of bioethics. A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010. Based on the pharmacists' attitude toward common ethical problems, 9 Likert-type scale scenarios were designed. A thousand pharmacists were surveyed and 505 questionnaires were filled. For the whole questionnaire the strongly disagree answer was the most ethical answer. On a scale from 1-5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57. For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers. The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme. The older participants (> 40 years) significantly had lower total score (P< 0.05) as well as the score of each theme (P< 0.05), except for non-maleficence. The work experience showed impact on the pharmacists' attitude toward autonomy and the participants with more than 5 years work experience significantly obtained lower score in this theme. Compiling ethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations. Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended. PMID:23908747

Sharif, Pooneh Salari; Javadi, Mohammadreza; Asghari, Fariba

2011-05-02

405

Pharmacy ethics: evaluation pharmacists' ethical attitude  

PubMed Central

Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making. Pharmacists’ knowledge as well as ethical reasoning affects their clinical decision-making. Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance. The study was designed to evaluate pharmacists’ attitude toward some principles of bioethics. A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010. Based on the pharmacists’ attitude toward common ethical problems, 9 Likert-type scale scenarios were designed. A thousand pharmacists were surveyed and 505 questionnaires were filled. For the whole questionnaire the strongly disagree answer was the most ethical answer. On a scale from 1–5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57. For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers. The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme. The older participants (> 40 years) significantly had lower total score (P< 0.05) as well as the score of each theme (P< 0.05), except for non-maleficence. The work experience showed impact on the pharmacists’ attitude toward autonomy and the participants with more than 5 years work experience significantly obtained lower score in this theme. Compiling ethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations. Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended.

Sharif, Pooneh Salari; Javadi, Mohammadreza; Asghari, Fariba

2011-01-01

406

Ethics in fetal medicine  

Microsoft Academic Search

In this chapter we provide an overview of current ethical issues in fetal medicine. We begin with an introduction to the language and concepts of ethics. We then show how ethical principles can be applied to fetal medicine. In this part of the chapter we introduce the concept of the fetus as a patient and explain its implications for directive

Frank A. Chervenak; Laurence B. McCullough

1999-01-01

407

Ethics for Fundraisers.  

ERIC Educational Resources Information Center

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…

Anderson, Albert

408

Who Decides Who Decides? Ethical Perspectives on Capacity and Decision-making  

Microsoft Academic Search

Capacity1 is at the heart of ethical decision making in healthcare. For those who subscribe to a principled approach to moral reasoning\\u000a (Gillon, 1985; Gillon and Lloyd, 1993; Beauchamp and Childress, 1994), autonomy is often said to be pre-eminent amongst the four principles of medical ethics2, or at least “first amongst equals” (Gillon, 2003). For those who prefer methods of

Deborah Bowman

409

Group-level ethics in managed care.  

PubMed

Managed care, the newest scheme for health care delivery, is under fire for skimping on quality, hiding information from patients and restricting free choice of providers. Medical group managers now face ethical questions quite unlike the medical ethics taught in medical schools. The new questions are about how the entire network of U.S. health care institutions work. Five principles can guide an appropriate ethics for this group-level reflection: 1) institutions are means to support the common-wealth, not ends in themselves; 2) people have a right to shape their health care options; 3) competition does not exclude collaboration; 4) a proper cost-benefit analysis will regard the entire community, not merely one institution; and 5) mission statements should be written by the people involved in delivering the care. PMID:10167627

Dunne, T

410

An innovative outcomes-based medical education program built on adult learning principles.  

PubMed

An innovative medical curriculum at the University of New South Wales (UNSW) has been developed through a highly collaborative process aimed at building faculty ownership and ongoing sustainability. The result is a novel capability-based program that features early clinical experience and small-group teaching, which offers students considerable flexibility and achieves a high degree of alignment between graduate outcomes, learning activities and assessments. Graduate capabilities that focus student learning on generic outcomes are described (critical evaluation, reflection, communication and teamwork) along with traditional outcomes in biomedical science, social aspects, clinical performance and ethics. Each two-year phase promotes a distinctive learning process to support and develop autonomous learning across six years. The approaches emphasize important adult education themes: student autonomy; learning from experience; collaborative learning; and adult teacher-learner relationships. Teaching in each phase draws on stages of the human life cycle to provide an explicit organization for the vertical integration of knowledge and skills. A learning environment that values the social nature of learning is fostered through the program's design and assessment system, which supports interdisciplinary integration and rewards students who exhibit self-direction. Assessment incorporates criterion referencing, interdisciplinary examinations, a balance between continuous and barrier assessments, peer feedback and performance assessments of clinical competence. A portfolio examination in each phase, in which students submit evidence of reflection and achievement for each capability, ensures overall alignment. PMID:17074700

McNeil, H Patrick; Hughes, Chris S; Toohey, Susan M; Dowton, S Bruce

2006-09-01

411

Medical confidentiality and patient privacy: the Jewish perspective.  

PubMed

This article presents the approach of Jewish law to the major issue of medical confidentiality and patient privacy. For an extensive discussion of Jewish medical ethics and an in-depth presentation of the Jewish view of 39 major issues in medical ethics, the reader is referred elsewhere [15]. Briefly, the Jewish view toward medical ethical subjects is predicated on the general principle of the supreme value of human life. In Judaism, all biblical and rabbinic laws are temporarily waived in order to save a human life. Physicians are obligated to heal patients from their illness, to induce remission and cure of disease whenever possible. Similarly, patients are obligated to lead healthy lifestyles, to consult physicians when they are sick and to be compliant with the physician's therapeutic recommendations. The Jewish view on medical confidentiality and patient privacy as presented in this essay flows from these general principles of Jewish medical ethics. PMID:16467003

Rosner, Fred

2006-02-01

412

Celan's poetics of alterity: lyric and the understanding of illness experience in medical ethics.  

PubMed

Psychopathology can render people strange and difficult to understand. Communication can lead to empathic understanding, which in turn can guide compassionate action. But communication depends on a shared conceptual world. How can language convey meanings that are not shared, that mark a divide between human beings or whole communities? A consideration of the poetics of Paul Celan sheds light on the power of language to bridge disparate worlds and on the ethical stance needed when empathy fails. Celan's poetics of alterity has implications for our efforts to understand individuals' illness experience as a grounding for the ethics of the clinical encounter. PMID:20433094

Kirmayer, Laurence J

2007-10-01

413

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

Federal Register 2010, 2011, 2012, 2013

...Regulatory Challenges in the Development of Pediatric Medical Countermeasures...Regulatory Challenges in the Development of Pediatric Medical Countermeasures...of the challenges of pediatric medical countermeasure development and deployment....

2012-01-18

414

Ethical decision making in the medical profession: An application of the theory of planned behavior  

Microsoft Academic Search

The present study applied Ajzen's (1985) theory of planned behavior to the explanation of ethical decision making. Nurses in three hospitals were provided with scenarios that depicted inadequate patient care and asked if they would report health professionals responsible for the situation. Study results suggest that the theory of planned behavior can explain a significant amount of variation in the

Donna M. Randall; Annetta M. Gibson

1991-01-01

415

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

ERIC Educational Resources Information Center

|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…

Iacono, T.; Carling-Jenkins, R.

2012-01-01

416

Teaching the Ethics of Biology.  

ERIC Educational Resources Information Center

|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…

Johansen, Carol K.; Harris, David E.

2000-01-01

417

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

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

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

2013-06-25

418

Implementation of the principle of as low as reasonably achievable (ALARA) for medical and dental personnel  

SciTech Connect

This report is part of a series prepared under the auspices of Scientific Committee 46, Operational Radiation Safety. It provides guidance on the process of implementing the as low as reasonably achievable'' (ALARA) principle for the use of radiation by medical and dental personnel. The use of cost-benefit analysis is recommended as a basic method upon which to base ALARA decisions. Examples are provided to illustrate the ALARA principle as a process of optimization and to provide a starting point for the development of individualized ALARA programs. NCRP Report No. 91, Recommendations on Limits for Exposure to Ionizing Radiation, calls for the use of reference ranges for occupational exposures. This report recommends the use of 2 reference ranges, one based on individual dose equivalents, and the other based on collective dose equivalent. In accordance with the recommendations of NCRP Report No. 82, SI Units in Radiation Protection and Measurements, as of January 1990, only SI units are used in the text. Readers needing factors for conversion of SI to conventional units are encouraged to consult Report No. 82. 84 refs., 10 figs., 10 tabs.

Not Available

1990-12-31

419

Ethical Principles Associated with the Publication of Research in ASHA's Scholarly Journals: Importance and Adequacy of Coverage  

ERIC Educational Resources Information Center

|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…

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

420

Ethical Principles Associated with the Publication of Research in ASHA's Scholarly Journals: Importance and Adequacy of Coverage  

ERIC Educational Resources Information Center

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…

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

421

HIV/AIDS reduces the relevance of the principle of individual medical confidentiality among the Bantu people of Southern Africa.  

PubMed

The principle of individual medical confidentiality is one of the moral principles that Africa inherited unquestioningly from the West as part of Western medicine. The HIV/AIDS pandemic in Southern Africa has reduced the relevance of the principle of individual medical confidentiality. Individual medical confidentiality has especially presented challenges for practitioners among the Bantu communities that are well known for their social inter-connectedness and the way they value their extended family relations. Individual confidentiality has raised several unforeseen problems for persons living with HIV/AIDS, ranging from stigma and isolation to feelings of dejection as it drives them away from their families as a way of trying to keep information about their conditions confidential. The involvement of family members in treatment decisions is in line with the philosophy of Ubuntu and serves to respect patients' and families' autonomy while at the same time benefiting the individual patient. PMID:19048391

Ndebele, Paul; Mfutso-Bengo, Joseph; Masiye, Francis

2008-01-01

422

[Ethics, knowledge and psychiatry: in Aulus Cornelius Celsus' De Medicina].  

PubMed

Modern medicine has many roots on greco-roman practice of the medical art. The authors analyse the work De Medicina by Aulus Cornelius Celsus. They look upon the nature of the medical knowledge, the principles of ethics, causality and describe the mental disorders (phrenitis, depression, third insanity, seizure disorder and womb disease), with special detail to signs and symptoms, treatment and prognosis. An association with current medical knowledge is established. PMID:18282440

Trancas, Bruno; Borja Santos, Nuno

2008-01-24

423

Ethics committees and achievement of good clinical practice.  

PubMed

Local ethics committees (institutional review boards, or similar bodies) were established during the last decades at (bio)medical research institutions worldwide to serve as review bodies of the proposed research projects (inclusive protocols of clinical trials), and also to monitor if the ethical principles, including the requirements of good practice (clinical, laboratory, and scientific) are respected and fulfilled during the conduct of research projects. Existing pluralism of the philosophical background on which contemporary bioethics theories are developed is questioning seriously the ancient traditions of Hippocratic, non-utilitarian medical ethics, trying to promote more utilitarian and secular approaches. Individual physicians, or researchers, as well as the ethics committee itself, are faced today with complicated ethical dilemmas, that frequently have to be solved in the atmosphere of considerable social, collegiate, economical, and time pressures, and sometimes without helpful guidance of appropriate legislation. An interesting possibility of how to overcome some of the pitfalls of the ethics review process is to express a common ethical responsibility for the research project or trial protocol in a statement of most (or all) parties involved (such as the principal investigator, sponsor, ethics committee, the patient, "society'). Such an approach has proven helpful in enhancing concrete deliberations of ethics committees-established in Slovakia since 1991 according to the requirements of the national guidelines issued by the Slovak Ministry of Health. PMID:8953810

Glasa, J; Holomán, J; Klepanec, J; Soltés, L

424

Ethics education and physician morality  

Microsoft Academic Search

Medical ethics education remains an important venue of moral education. In spite of the intensity of these efforts, the desired outcomes of medical ethics education remain obscure, undefined and largely untested. In the first part of this study, the goals of medical ethics are operationalized along cognitive, behavioral and attitudinal dimensions. This includes a written moral judgment test, a survey

Michael L. Gross

1999-01-01

425

Ethics, patient rights and staff attitudes in Shanghai's psychiatric hospitals  

PubMed Central

Background Adherence to ethical principles in clinical research and practice is becoming topical issue in China, where the prevalence of mental illness is rising, but treatment facilities remain underdeveloped. This paper reports on a study aiming to understand the ethical knowledge and attitudes of Chinese mental health professionals in relation to the process of diagnosis and treatment, informed consent, and privacy protection in clinical trials. Methods A self-administered survey was completed by 1110 medical staff recruited from Shanghai’s 22 psychiatric hospitals. Simple random selection methods were used to identify target individuals from the computerized registry of staff. Results The final sample for analysis consisted 1094 medical staff (including 523 doctors, 542 nurses, 8 pharmacologists and 21 other staff). The majority reported that their medical institutions had not established an Ethics Committee (87.8%) and agreed that Ethics Committees should be set up in their institutions (72.9%). Approximately half (52%) had not received systematic education in ethics, and almost all (89.1%) of the staff thought it was necessary. Nearly all participants (90.0%) knew the Shanghai Mental Health Regulations which was the first local regulations relating to mental health in China, but only 11% and 16.6% respectively knew of the Nuremberg Code and the Declaration of Helsinki. About half (51.8%) thought that the guardian should make the decision as to whether the patient participated in clinical trials or not. Conclusions The study indicates that most psychiatric hospitals in Shanghai have no Medical Ethics Committee. More than half the medical staff had not received systematic education and training in medical ethics and they have insufficient knowledge of the ethical issues related to clinical practice and trials. Training in ethics is recommended for medical staff during their training and as ongoing professional development.

2012-01-01

426

[Medical, legal and ethical aspects of fertility preservation in cancer survivor].  

PubMed

In recent years the number of the young women in fertile age which are oncologically treated is increasing. For these women chemotherapy and radiotherapy introduces potential risk of reproductive dysfunctions. Present techniques of assisted reproduction are offering possibilities to save reproductive functions even after the oncological treatment. As a perspective outlook seems to be frozen premature oocytes with IVM and fertilisation. With these fertility savings methods are naturally coming up some of the ethical and legal issues. PMID:22702076

Záhumenský, J; Kucera, E; Kosová, T; Zmrhal, J; Stejskal, M; Stejskal, D

2012-04-01

427

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues  

Microsoft Academic Search

Purpose  The increasing gap between numbers of individuals awaiting organ replacement surgery and the supply of organs available for\\u000a transplant underpins attempts to increase the number of organs available. One practice, used in other countries, is the recovery\\u000a of organs from non-heart-beating organ donors (NHBD). The purpose of this review is to discuss ethical issues surrounding\\u000a the use of organs from

Christopher James Doig; Graeme Rocker

2003-01-01

428

Establishment of a successful donor embryo program: medical, ethical, and policy issues  

Microsoft Academic Search

Objective: To determine how couples prefer to dispose of their extra embryos and to establish a donor embryo program for the treatment of infertile couples.Design: Cohort study.Setting: University-based IVF program.Patient(s): Patients (n = 365) with cryopreserved embryos in storage for >2 years and eight patients who desired donated embryos for transfer.Intervention(s): An IVF ethics committee was formed to discuss the

Bradley J Van Voorhis; Dan M Grinstead; Amy E. T Sparks; Janice L Gerard; Robert F Weir

1999-01-01

429

Ethics out of Economics  

Microsoft Academic Search

Many economic problems are also ethical problems: should we value economic equality? how much should we care about preserving the environment? how should medical resources be divided between saving life and enhancing life? This book examines some of the practical issues that lie between economics and ethics, and shows how utility theory can contribute to ethics. John Broome's work has,

John Broome

430

Risk and supervised exercise: the example of anorexia to illustrate a new ethical issue in the traditional debates of medical ethics  

PubMed Central

Sport and physical activity is an area that remains relatively unexplored by contemporary bioethics. It is, however, an area in which important ethical issues arise. This paper explores the case of the participation of people with anorexia nervosa in exercise. Exercise is one of the central features of anorexia. The presence of anorexics in exercise classes is becoming an increasingly sensitive issue for instructors and fitness professionals. The ethics of teaching exercise to anorexics has, however, seldom, if ever, been addressed. Codes of ethics and legislation do not offer guidelines pertinent to the case and it is left unclear whether anorexics should be allowed to participate in exercise classes. It is shown by this paper that there are strong ethical reasons to let anorexics participate in exercise classes. However, the paper also explains why, despite these apparently cogent ethical reasons, there is no moral obligation to allow a person with anorexia to take part in exercise/sports activities.

Giordano, S

2005-01-01

431

Ethics and Communication  

PubMed Central

Ethics education aims to train physicians to identify and resolve ethical issues. To address ethical concerns, physicians may need to confront each other. We surveyed medical students to determine if their comfort challenging members of their ward teams about ethical issues varies by specialty and what attributes of students and their teams contributed to that comfort. Compared to other specialties, students felt significantly less comfortable challenging team members about ethical issues on surgery and obstetrics/gynecology. We suggest that ethics education must address the atmosphere on ward teams and give students skills to help them speak out despite their discomfort.

Clever, Sarah L; Edwards, Kelly A; Feudtner, Chris; Braddock, Clarence H

2001-01-01

432

Research ethics in dissertations: ethical issues and complexity of reasoning  

Microsoft Academic Search

BackgroundConducting ethically sound research is a fundamental principle of scientific inquiry. Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations.PurposeTo examine which research ethical topics were addressed and how these were presented in terms of complexity of reasoning in Swedish nurses' dissertations.MethodsAnalyses of ethical content and complexity of ethical reasoning were performed on 64 Swedish nurses'

S. Kjellstrom; S. N. Ross; B. Fridlund

2010-01-01

433

The ethical and legal implications of Jaffee v Redmond and the HIPAA medical privacy rule for psychotherapy and general psychiatry.  

PubMed

The 1996 Jaffee v Redmond US Supreme Court decision established a privilege for psychotherapeutic communications in the federal courts. The new privilege has both substantive and symbolic importance. In its strongly worded opinion in Jaffee v Redmond, the US Supreme Court made clear that confidentiality in psychotherapy takes precedence over certain other important societal goals. The new Health Insurance Portability and Accountability Act (HIPAA) medical privacy rule promulgated by the Department of Health and Human Services relies on Jaffee v Redmond in providing additional legal protections for confidential psychotherapy. Both the US Supreme Court's Jaffee v Redmond ruling and the HIPAA rule support the ethical protection of confidentiality of conversations between psychiatrists and patients. PMID:12232971

Mosher, Paul W; Swire, Peter P

2002-09-01

434

Working ethics: William Beaumont, Alexis St. Martin, and medical research in antebellum America.  

PubMed

Analyzing William Beaumont's relationship with his experimental subject, Alexis St. Martin, this article demonstrates how the "research ethics" of antebellum America were predicated on models of employment, servitude, and labor. The association between Beaumont and St. Martin drew from and was understood in terms of the ideas and practices of contract labor, informal domestic servitude, indentures, and military service. Beaumont and St. Martin lived through an important period of transition in which personal master-servant relations existed alongside the "free" contract labor of market capitalism. Their relationship reflected and helped constitute important developments in nineteenth-century American labor history. PMID:20657054

Green, Alexa

2010-01-01

435

Critical reflections on the principle of beneficence in biomedicine  

PubMed Central

Medical ethics as a scholarly discipline and a system of moral principles that apply values and judgments to the practice of medicine encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, anthropology and sociology. As such there are a number of values in medical ethics such as autonomy, non-maleficence, confidentiality, dignity, honesty, justice and beneficence, among others. These values act as guidelines for professionals in the medical fraternity and are therefore used to judge different cases in the fraternity. For purposes of this work, this paper examines the principle of beneficence in biomedicine. Using both hypothetical cases and others in real life situations, the paper reflects on the implications of beneficence in biomedicine. It argues that the principle of beneficence is a prima facie obligation that should “always be acted upon unless it conflicts on a particular occasion with an equal or stronger principle”.

Munyaradzi, Mawere

2012-01-01

436

Identifying and addressing potential conflict of interest: a professional medical organization's code of ethics.  

PubMed

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

Heim, Lori

437

[Jean-Jacques Rosseau the vitalist. The moralization of medical hygiene between diet and ethical food].  

PubMed

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

Menin, Marco

2012-01-01

438

Teaching ethics in Europe  

PubMed Central

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.

Claudot, Frederique; Alla, Francois; Ducrocq, Xavier; Coudane, Henry

2007-01-01

439

Similarities in Business and IT Professional Ethics: The Need for and Development of A Comprehensive Code of Ethics  

Microsoft Academic Search

The study of business ethics has led to the development of various principles that are the foundation of good and ethical business practices. A corresponding study of Information Technology (IT) professionals’ ethics has led to the conclusion that good ethics in the development and uses of information technology correspond to the basic business principle that good ethics is good business.

Dinah Payne; Brett J. L. Landry

2005-01-01

440

[Continuous sedation: practical and ethical aspects].  

PubMed

Continuous sedation is an acknowledged medical practice in the management of refractory symptoms at the end of life. Guidelines and recommendations have been proposed in palliative care. This paper presents the state-of-the-art (definitions, indications, technical aspects) on continuous sedation followed by an ethical reflection essentially based on the "double effect" principle, on the impact on life expectancy and the assimilation of continuous sedation as a "natural death". Distinction between continuous sedation and legal euthanasia is clarified. PMID:23534311

Lossignol, D; Damas, F

441

Morality in flux: medical ethics dilemmas in the People's Republic of China.  

PubMed

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

Qiu, Ren-Zong

1991-03-01

442

Ethical Aspects of Geriatric Patients' Rights to Refuse Treatment and to Receive Limited Medical Resources.  

ERIC Educational Resources Information Center

Discusses two of the most formidable bioethical challenges over the next decades which relate to disabilities and aging: elders' exercise of autonomy and the just allocation of resources to older patients. Offers suggestions for developing principles for the treatment of elders. (Author/ABL)

Howe, Edmund G.

1988-01-01

443

Brand name versus generic drugs: The ethical quandary in caring for our sophisticated patients while trying to reduce health-care costs: Facts and controversies.  

PubMed

Medical ethics are the values and guidelines that govern decisions made in medical practice. Four prima facie moral principles can serve as a framework to help physicians analyze problems and make ethical decisions: (1) respect for autonomy, (2) beneficence, (3) non-maleficence, and (4) justice. With the cost of health care rising, all parties involved in the delivery of health care need to work to reduce costs, while continuing to provide quality care to our patients. One mechanism to reduce costs is to increase utilization of generic medications in daily practice, but there are many ethical issues inherent in utilizing brand name versus generic medications in dermatology. PMID:24160285

Payette, Michael; Grant-Kels, Jane M

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