Sample records for medical ethics principles

  1. Shannon and Jake An Application of Medical Ethics Principles

    NSDL National Science Digital Library

    Doug Knutson

    2006-01-01

    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.

  2. WORLD MEDICAL ASSOCIATION DECLARATION OF HELSINKI Ethical Principles for Medical Research Involving Human Subjects

    E-print Network

    Pfeifer, Holger

    1 WORLD MEDICAL ASSOCIATION DECLARATION OF HELSINKI Ethical Principles for Medical Research, October 2008 A. INTRODUCTION 1. The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human subjects, including

  3. [Ethics and medical research: principles, guidelines, and regulations].

    PubMed

    de Castilho, Euclides Ayres; Kalil, Jorge

    2005-01-01

    The issue of ethics in medical research grew in importance at the end of World War II, after the Nuremberg Code. In this period, some cases in the United States had demonstrated the need for the establishment of rules and procedures in medical research. In this article, the authors discuss some ethical concepts and their philosophical basis, stressing aspects related to research. Ethics in medical research is based upon three items: peer approaches, subject informed consent, and confidentiality of individual obtained data. The authors also summarize the Brazilian laws and directives to follow the precepts and to control the process of ethical issues in research with human participants. Finally, they approach practical questions of the Informed Consent Form as a consequence of their experiences analyzing more than one thousand research projects per year as members of the Internal Review Board of the University of São Paulo School of Medicine, São Paulo, Brazil. PMID:16082484

  4. Principles of Biomedical Ethics

    PubMed Central

    Athar, Shahid

    2012-01-01

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

  5. Ethics: A Theory of Medical Ethics.

    PubMed

    Brody, Howard

    This book review characterizes Robert Veatch's A Theory of Medical Ethics as a "third-generation" treatise that looks beyond case- and issue-oriented analysis to develop the theoretical bases of a "true system of medical ethics." Veatch proposes a "draft medical ethical covenant" based on a "triple contract" model, in which the moral principles of contract keeping, autonomy, honesty, avoiding killing, and justice govern the physician's relationship to both individual patients and society. PMID:11652360

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

    PubMed Central

    Ambrose, Charles T.

    2005-01-01

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

  7. Business ethics, medical ethics and economic medicalization

    Microsoft Academic Search

    Geoffrey Poitras

    2009-01-01

    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

  8. Medical Ethics

    MedlinePLUS

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

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

    PubMed Central

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

    2009-01-01

    Abstract The medical management of differences of sex development (DSD)/intersex in early childhood has been criticized by patients’ advocates as well as bioethicists from an ethical point of view. Some call for a moratorium of any feminizing or masculinizing operations before the age of consent except for medical emergencies. No exhaustive ethical guidelines have been published until now. In particular, the role of the parents as legal representatives of the child is controversial. In the article, we develop, discuss, and present ethical principles and recommendations for the medical management of intersex/DSD in children and adolescents. We specify three basic ethical principles that have to be respected and substantiate them. The article includes a critical discussion of the best interest of the child and of family privacy. The argumentation draws upon recommendations by the working group “Bioethics and Intersex” within the German Network DSD/Intersex, which are presented in detail. Unlike other recommendations with regard to intersex, these guidelines represent a comprehensive view of the perspectives of clinicians, patients, and their families. Conclusion The working group identified three leading ethical principles that apply to DSD management: (1) to foster the well-being of the child and the future adult, (2) to uphold the rights of children and adolescents to participate in and/or self-determine decisions that affect them now or later, and (3) to respect the family and parent–child relationships. Nine recommendations for the management of DSD indicate how these ethical principles can spelled out and balanced against each other in the clinical setting. PMID:19841941

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

    PubMed

    2014-01-01

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

  11. How Medical Students Think about Ethical Issues.

    ERIC Educational Resources Information Center

    Shapiro, Johanna; Miller, Ron

    1994-01-01

    A study in which 92 second-year medical students wrote essays on ethical dilemmas found most students were familiar with major ethical theories and principles currently in use and able to apply them appropriately. Gender differences were found in choice of topic, ethical principles used, and level of personal orientation. (Author/MSE)

  12. [Ethical principles in psychiatric action].

    PubMed

    Rüther, Eckart

    2014-07-01

    There is no specific psychiatric ethic. The ethical principles for practical actions in psychiatry have to be adapted on the basis of the generally accepted ethical principles, which are based on psychobiologically developed ethic of love: honesty, discretion, empathy, patience, distance, consistency, accountability, tolerance, economic neutrality. PMID:24983582

  13. Principles for Professional Ethics.

    ERIC Educational Resources Information Center

    School Psychology Review, 1997

    1997-01-01

    Reviews principles based on assumptions that school psychologists will act as advocates for their clients and will do no harm. Includes sections on professional competency, relationships and responsibilities, and practice in public and private settings. Presents extensive information on procedural guidelines for adjudication of ethical complaints.…

  14. Code of Ethics: Principles for Ethical Leadership

    PubMed Central

    Flite, Cathy A.; Harman, Laurinda B.

    2013-01-01

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

  15. Ethics in Medical Research and Publication

    PubMed Central

    Masic, Izet; Hodzic, Ajla; Mulic, Smaila

    2014-01-01

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

  16. Islamic medical ethics: a primer.

    PubMed

    Padela, Aasim I

    2007-03-01

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

  17. The implications of medical ethics.

    PubMed Central

    Thompson, I. E.

    1976-01-01

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

  18. Does pregnancy affect medical ethical decision making?

    Microsoft Academic Search

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

    1998-01-01

    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

  19. Modeling Medical Ethics through Intelligent Agents

    NASA Astrophysics Data System (ADS)

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

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

  20. [Human dignity and medical ethics].

    PubMed

    Munzarová, Marta

    2011-01-01

    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

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

    PubMed

    Singh, Arjun

    2010-07-01

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

  2. [Medical ethics in residency training].

    PubMed

    Civaner, Murat; Sarikaya, Ozlem; Balcio?lu, Harun

    2009-04-01

    Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be's and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician's working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed. PMID:19357056

  3. How Many Principles for Public Health Ethics?

    PubMed

    Coughlin, Steven S

    2008-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Preston, Tom; Kelly, Michael

    2006-01-01

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

  6. Risk and medical ethics.

    PubMed Central

    Pochin, E

    1982-01-01

    Quantitative estimates of risk, and their comparison with quantitative estimates of benefit, contribute usefully to decision-making in many fields. In medicine, our assessments of the probability of harm, and of the likelihood of benefit, resulting from many procedures are at present very limited. Moreover, the comparison of risk and of benefit is difficult to make in any quantitative way, whether for a procedure in general or, even more so, for its application in any particular patient. Yet it must be ethically insecure to propose or to use a procedure without some assessment, however approximate, of the hazards involved, and without some indication of whether those hazards will be clearly offset by the likelihood of benefit that should result from use of the procedure. PMID:7154031

  7. Developing medical ethics in China's reform era.

    PubMed

    Ip, Po-Keung

    2005-05-01

    The paper gives an analytical synopsis of the problem of developing medical ethics in the early half of the 1990s in China, as perceived by Chinese scholars and medical professionals interested in medical ethics. The views captured and analyzed here were expressed in one of the two major journals on medical ethics in China: Chinese Medical Ethics. The economic reform unleashed profound changes in Chinese society, including in the medical field, creating irregularities and improprieties in the profession. Furthermore, the market reform also created new values that were in tension with existing values. In this transitional period, Chinese medical ethicists saw the need to rebuild medical morality for the new era. Using the code of conduct promulgated by the Chinese Ministry of Health in 1989 as a basis, assessment and education aspects of the institutionalization of medical ethics are discussed. In addition to institutional problems of institutionalising ethics, there are philosophical and methodological issues that are not easy to solve. After all, to institutionalize medical ethics is no easy task for a country as old and as big as China. Chinese medical ethicists seem ready to confront these difficulties in their effort to develop medical ethics in Reform China. PMID:15842726

  8. Medical ethics under managed care.

    PubMed

    Schwartz, P

    1996-01-01

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

  9. Faculty ethics: ideal principles with practical applications.

    PubMed

    Reybold, L Earle

    2009-01-01

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

  10. Linking ethical principles with community practice.

    PubMed

    Ross, M E

    1993-01-01

    Nurses must frequently make arduous decisions when faced with ethical dilemmas that occur in clinical practice. Utilizing ethical principles for analyzing and reflecting on the issues may ease this difficult task. In addition, the nurse involved may experience less anxiety and uncertainty over whether or not the correct decision was made. The purpose of this article is to present a case study that involves the allocation of a scarce resource that posed an ethical dilemma for a nursing instructor and her students in a community health setting. Toulmin's framework is utilized for analyzing this dilemma. PMID:8126529

  11. Beyond principles: virtue ethics in hospice and palliative care.

    PubMed

    Giblin, Marie J

    2002-01-01

    Living ethically in the face of death is a major challenge for the ill person, the family, and the hospice staff. Beyond the recognized need for ethical decision-making regarding medical principles, there are decisions about character for all involved: "What kind of person will I be?" "What kind of family will we be?" What kind of caregiver will I be?" "What kind of community will we be? This article is a discussion of virtues that are appropriate in hospice staff and volunteers: compassion/empathy, faithfulness, justice/advocacy and practical wisdom. The author calls for a wider sharing of their knowledge and experience. PMID:12141787

  12. Ethical analysis of non-medical fetal ultrasound.

    PubMed

    Leung, John Lai Yin; Pang, Samantha Mei Che

    2009-09-01

    Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. PMID:19671649

  13. Teaching medical ethics in Basra: perspective of students and graduates.

    PubMed

    Yacoub, A A; Ajeel, N A

    2000-07-01

    The University of Basra Medical College introduced a course on medical ethics for undergraduate students in 1994. We explored the opinions of 54 graduates and 52 final-year medical students about the benefits they perceive they gained from the course and its relevance to their training or practice. About 31% of students and 34% of graduates thought the course was practically and theoretically useful. Over 80% of graduates and students thought the course was either very relevant or relevant to some extent to the practice of medicine. When asked to recall the important ethical issues taught in the course, 52% of graduates and 44% of students listed patient-doctor relationship. Confidentiality, physician liability and ethical issues concerning recent medical innovations were listed by few respondents. Only 6% of both graduates and students were able to list the four principles of medical ethics as described by Raanan. The self-learning component of the course should be developed to strengthen ethical reasoning and judgment in decision-making. PMID:11794075

  14. Ethical Principles of Psychologists and Code of Conduct.

    ERIC Educational Resources Information Center

    American Psychologist, 2002

    2002-01-01

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

  15. The literature of medical ethics: Bernard Häring

    PubMed Central

    Soane, Brendan

    1977-01-01

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

  16. Nurse prescribing ethics and medical marketing.

    PubMed

    Adams, J

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

  17. The Terri Schiavo case: legal, ethical, and medical perspectives.

    PubMed

    Perry, Joshua E; Churchill, Larry R; Kirshner, Howard S

    2005-11-15

    Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care. First, the authors review the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Second, they examine the legal history, including the 2000 trial, the 2002 evidentiary hearing, and the subsequent appeals. The authors argue that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history. Third, they review alternative ethical frameworks for understanding the Terri Schiavo case and contend that the principle of respect for autonomy is paramount in this case and in similar cases. Far from being unusual, the manner in which Terri Schiavo's case was reviewed and the basis for the decision reflect a broad medical, legal, and ethical consensus. Greater clarity regarding the persistent vegetative state, less apprehension of the presumed mysteries of legal proceedings, and greater appreciation of the ethical principles at work are the chief benefits obtained from studying this provocative case. PMID:16287796

  18. Casuistry: A Complement to Principle Ethics and a Foundation for Ethical Decisions

    ERIC Educational Resources Information Center

    Freeman, Stephen J.; Francis, Perry C.

    2006-01-01

    Ethical dilemmas within any system are created when moral/ethical principles, rules, or guidelines can be cited for opposing actions with neither side presenting the obvious, right course to follow. This condition exposes the intricate interrelationship between abstract moral/ethical principles and the description and evaluation of real-life…

  19. The use of narrative in Jewish medical ethics.

    PubMed

    Jotkowitz, Alan

    2013-09-01

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

  20. Treating Ed A Medical Ethics Case Study

    NSDL National Science Digital Library

    Eric Ribbens

    2008-01-01

    Ed is dying. How should his wishes for medical treatment be carried out? As the case unfolds, students explore the rights and responsibilities of doctors, patients, and patient representatives regarding difficult medical decisions. Specifically, students consider the ramifications of Advance Directives and Durable Powers of Attorney. The case was written for an introductory biology course, but could easily be used in or modified for a human anatomy and physiology, introductory nursing, or medical ethics course.

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

    PubMed Central

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

    2009-01-01

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

  2. Medical ethics, bioethics and research ethics education perspectives in South East Europe in graduate medical education.

    PubMed

    Mijaljica, Goran

    2014-03-01

    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

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

    ERIC Educational Resources Information Center

    Tilley, Susan; Gormley, Louise

    2007-01-01

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

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

    PubMed

    Barrio Maestre, José María

    2015-01-01

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

  5. Perception of Physicians and Medical Students on common Ethical Dilemmas in a Pakistani Medical Institute

    Microsoft Academic Search

    Bushra Khizar; Mobeen Iqbal

    Knowledge about medical ethics is limited in Pakistan. The teaching of ethics in both under and postgraduate education is generally not formal. The aim of the survey was to assess the knowledge, attitudes and practices among the medical professionals in relation to medical ethics in an attempt to identify the medical ethics learning needs of Pakistani doctors. A self-administered structured

  6. Medical ethics and education for social responsibility.

    PubMed Central

    Roemer, M. I.

    1980-01-01

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

  7. [Medical expert opinion--credibility, ethics, remuneration].

    PubMed

    Sahar, Avraham

    2007-07-01

    Israeli Law requires a Personal Injury Claim to be supported by an Expert Medical Opinion. Such evidence provides the Court with information essential for the evaluation of scientific material, which is beyond the Court's "judicial knowledge". Incongruent Expert Opinions are not necessarily the result of deceit. Experts are entitled to differences in their respective evaluation and interpretation of data and conflicting medical opinions may be legitimate. The Court's duty and prerogative is to select the "legally correct" opinion. The sole tool at the Court's disposal is precise and logical thinking, aided by principles set by the U.S. Supreme Court for the evaluation of scientific evidence, and adopted by the Israeli Court. The choice of the "correct" opinion centers on it's objectivity. A court-appointed expert is not necessarily an effective solution. Remuneration of the expert by the interested party increases the level of mistrust. The difficult questions concerning the credibility of an opinion arise as the result of insufficient specific expertise of the witness, presentation by a pretender to expertise or plain misrepresentation of data, excerpts of literature etc. Such transgressions are best exposed by the opposing party's expert and attorney. The court has effective means for the control of such behavior. The fraudulent expert witness is neither immune to criminal prosecution, nor to civil suit. IMA's Code of Ethics for Experts is adequate. Expert's fees should be consistent with the effort involved, as well as with the expert's rank and experience. Any linkage of fees to the outcome of the procedure should be prohibited, as well as the intervention of "contractors". Attempts to limit experts' fees, may result in the abstention of the most knowledgeable specialists from such duties. The blame for a false opinion does not lie with the paying party, it is mostly the witness who is responsible. PMID:17803167

  8. Jewish medical ethics – a brief overview

    Microsoft Academic Search

    Immanuel Jakobovits

    1983-01-01

    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.

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

    PubMed Central

    Wertheimer, Alan

    2015-01-01

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

  10. Ethical problems in medically assisted procreation

    Microsoft Academic Search

    Marc Germond

    1998-01-01

    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

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

    PubMed

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

    2013-03-01

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

  12. Medically assisted reproduction and ethical challenges

    SciTech Connect

    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

    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.

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

    PubMed

    Ruyter, K W

    1997-12-10

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

  14. Are medical ethics universal or culture specific.

    PubMed

    Ahmed, Furqaan

    2013-08-01

    In our society and culture where family is of utmost importance, sometimes I wonder how much of a doctor's duty is to the patient and how much is to the whole family. As a medical student, I remember being told by my professors that we should treat the patient as a whole and not focus on just one problem or organ system. Similarly when practicing medicine in Pakistan, one cannot treat the patient alone and ignore the family. How much should relatives' wishes be taken into account when dealing with a patient Don't patients have a right to their medical information When, how, and by whom can that right be waived What role does culture play when debating medical ethics. PMID:23919215

  15. Bioethics: Applying the Basic Principles to Resolve an Ethical Dilemma

    Microsoft Academic Search

    Neel Karnani

    Given the complexity of medical issues and the often emo- tionally charged situation at hand, clinicians need a moral compass to help guide them when dealing with ethical problems. Beauchamp and Childress have proposed a \\

  16. An international survey of medical ethics curricula in Asia.

    PubMed Central

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

    1999-01-01

    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. PMID:10635508

  17. The ethics of an ordinary medical technology.

    PubMed

    van Manen, Michael A

    2015-07-01

    Some routinely applied hospital technologies may have unintended consequences for patients and their families. The neonatal cardiorespiratory monitor, a computer-like display used to show an infant's vital functions, is one such technology that may become part of a parent's day-to-day being with his or her hospitalized child. In this phenomenological study, I explored how the monitor may mediate parental sensibilities, reshaping the contact of parent and child. This exploration speaks to understanding the relational ethics of even the seemingly most ordinary of medical technologies in clinical contexts. PMID:25296652

  18. The medical ethics of Erasmus and the physician-patient relationship.

    PubMed

    Albury, W R; Weisz, G M

    2001-06-01

    Desiderius Erasmus set out his views on medical ethics just over 500 years ago. Applying the characteristic approach of Renaissance Humanism, he drew upon a variety of classical sources to develop his own account of medical obligation. Of particular interest is Erasmus's attention to the patient's duties as well as the physician's. By treating this reciprocal relationship as a friendship between extreme unequals, Erasmus was able to maintain the nobility of the medical art and at the same time deal with the culturally sensitive issue of payment for physicians' services. The use of physician-patient reciprocity as a principle of medical ethics has until recently been considered a novel feature of nineteenth-century medical codes. As Erasmus's treatment of physician-patient reciprocity arose from a classical conception of friendship, there may be grounds for reconsidering the role of friendship in other discourses on medical ethics from the Renaissance to the nineteenth century. PMID:16381098

  19. [How do first codes of medical ethics inspire contemporary physicians?].

    PubMed

    Paprocka-Lipi?ska, Anna; Basi?ska, Krystyna

    2014-02-01

    First codes of medical ethics appeared between 18th and 19th century. Their formation was inspired by changes that happened in medicine, positive in general but with some negative setbacks. Those negative consequences revealed the need to codify all those ethical duties, which were formerly passed from generation to generation by the word of mouth and individual example by master physicians. 210 years has passed since the publication of "Medical Ethics" by Thomas Percival, yet essential ethical guidelines remain the same. Similarly, ethical codes published in Poland in 19 century can still be an inspiration to modem physicians. PMID:24720115

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

    PubMed

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

    2014-10-16

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

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

    PubMed Central

    Thornton, T

    2006-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2011-10-15

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

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

    PubMed Central

    Parker, M

    1995-01-01

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

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

    PubMed

    Summers, Craig

    1992-01-01

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

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

    PubMed

    Weinstock, Robert

    2015-03-01

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

  7. Empirical investigation of the ethical reasoning of physicians and molecular biologists – the importance of the four principles of biomedical ethics

    Microsoft Academic Search

    Mette Ebbesen; Birthe D Pedersen

    2007-01-01

    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

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

    PubMed Central

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

    2013-01-01

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

  9. [Professional and ethical medical expert quality].

    PubMed

    Ivekovi?, Renata

    2008-01-01

    The work of court experts, including those of medical profession, is ruled by Regulations on standing court experts. The Regulations determine requirements for performing the job of court expertise, rights and duties of court experts, awards and remuneration for their work. The ethical codex determines relation of experts to performance of expertise, to court and parties, to colleagues court experts and to the community. The expert must obey the rules on performance of the expertise, complete all his duties, protect respectability of all court experts, and justify trust of legal authorities. In relationship with the court, the expert must respond to court summons, give his finding and opinion, and come to hearing summons. PMID:19146190

  10. Good medical ethics, justice and provincial globalism.

    PubMed

    Prah Ruger, Jennifer

    2015-01-01

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

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

    PubMed

    Duquenoy, Penny; George, Carlisle; Solomonides, Anthony

    2008-12-01

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

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

    PubMed

    Finlay, Ilora G

    2015-01-01

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

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

    Microsoft Academic Search

    Anthony S Oberman; Tal Brosh-Nissimov; Nachman Ash

    2010-01-01

    A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less

  14. The ethics and science of medicating children.

    PubMed

    Sparks, Jacqueline A; Duncan, Barry L

    2004-01-01

    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

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

    ERIC Educational Resources Information Center

    Bodi, Sonia

    1998-01-01

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

  16. Islamic medical ethics in the 20th century.

    PubMed Central

    Rispler-Chaim, V

    1989-01-01

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

  17. Medical ethics in the developing world: a liberation theology perspective.

    PubMed

    Anjos, M F

    1996-12-01

    Standard medical ethical analyses typically focus on the physician/patient relationship, patient autonomy, and the clinical encounter. For Liberation Theology this amounts to neglecting the larger context of social injustice. Medicine is a social institution. Any medical ethics which purports to provide an ethics of medicine and medical practice must necessarily address the larger social issues of class structure, poverty and access to adequate health care. Liberation Theology provides a very specific perspective that draws on the needs of the poverty stricken, assesses the relationship among social classes, and focuses on societal conditions. Given such an analysis, medical ethics is reconfigured as concerned not only with clinical encounters but also with background cultural conditions and social justice. PMID:9061596

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

    PubMed Central

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

    2014-01-01

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

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

    Microsoft Academic Search

    A. M. Jafarey; A. Farooqui

    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

  20. [Civil, criminal and ethical liability of medical doctors].

    PubMed

    Udelsmann, Artur

    2002-01-01

    In the last years doctors have been the target of a growing number of civil, criminal law suits, as well as ethical procedures. Medicine is a widely targeted career, not only owing to its inherent risks, but also owing to a mistaken approach of the Judiciary Power about the obligations of medical doctors. Decisions of the Medical Board in ethical procedures have an impact in civil and criminal justice and therefore should be followed closely. The purpose of this review is to provide a wide view from a doctor-lawyer perspective of cases involving civil, criminal liability of anesthesiologists as well as ethical procedures against them, in an effort to make them comprehensible to doctors. After a brief historical introduction civil liability foundations and legal articles are examined. Responsibilities of doctors, hospitals and health insurance providers are discussed separately, as well as reparation mechanisms. Crimes possible to occur during medical practice and respective penalties are described; the direct relationship between crime and civil reparation is demonstrated. The administrative nature of ethical procedure is described, emphasizing that the legal character of its penalties often serve as grounds for civil and criminal justice decisions. Prevention is still the best medicine. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions. Doctors should have some knowledge of juridical mechanisms in lawsuits and ethical procedures, but should not take defense initiatives without prior consultation of an attorney. Civil, criminal and ethical liability of physicians. PMID:12205537

  1. A PRINCIPLE-BASED ANALYSIS OF THE 2002 AMERICAN PSYCHOLOGICAL ASSOCIATION ETHICS CODE

    Microsoft Academic Search

    Samuel Knapp; Leon VandeCreek

    2004-01-01

    The authors adopt a position that the Standards in the American Psychological Association (APA; 2002) Ethics Code should be based on or be logically related to some underlying ethical theory. The authors then review the 2002 APA Ethics Code from the standpoint of principle-based (prima facie) ethics. Their analysis shows that almost all of the enforceable standards in the 2002

  2. The Relative Importance of the Ethical Principles Adopted by the American Psychological Association

    Microsoft Academic Search

    Thomas Hadjistavropoulos; David C. Malloy; Donald Sharpe; Sheryl M. Green; Shannon Fuchs-Lacelle

    2002-01-01

    A primary purpose of a code of ethics is to assist members of an organization in making consistent choices when faced with ethical dilemmas. In instances where two or more ethical principles are in conflict with one another, decision-makers are typically left to determine which of the two should be given most weight. Nonetheless, in the code of ethics adopted

  3. [Medical ethics in the undergraduate medical curriculum and in the health care system].

    PubMed

    Körtner, Ulrich H J; Hofhansl, Angelika; Dinges, Stefan

    2014-01-01

    In German speaking areas, in the scientific establishment which is occupied with medical ethics in the narrower and wider senses, a vehement discussion has developed as to whether or not medical practitioners must ultimately advocate that which is understood to be modern medical ethics. Against the background of this discussion, this article takes up a position on these questions, not only theoretically, but also with reference to the fields of practice of medical studies, hospitals, and the health system. The article presents the proposals of the Institute for Ethics and Law in Medicine (University of Vienna) for the evaluation and further development of the theme of ethics within the framework of the Medical Curriculum of Vienna (MCW). Among other things, this requires an integrated model of levels of ethical competence. PMID:24322387

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

    PubMed

    Asgary, Ramin; Junck, Emily

    2013-10-01

    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

  5. Professional Decisions and Ethical Values in Medical and Law Students.

    ERIC Educational Resources Information Center

    Rezler, Agnes G.; And Others

    1990-01-01

    This project evaluated and compared the values used by medical and law students when dealing with ethical dilemmas in the practice of law and medicine. The Professional Decisions and Values Test was given to 77 medical students and 92 law students. Differences were noted on beneficence, professional responsibility, and harm avoidance. (MLW)

  6. [Ethic review on clinical experiments of medical devices in medical institutions].

    PubMed

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed. PMID:22097752

  7. Medical ethical guidelines: Intensive-care interventions.

    PubMed

    Swiss Academy Of Medical Sciences; Stocker, Reto; Berner, Michel; Binet, Isabelle; Bürgi, Ulrich; Fischer, Johannes; Gardaz, Valérie; Grob, Daniel; Hager, Ursula; Kätterer, Christian; Kind, Christian; Ricou, Bara; Salathé, Michelle; Wildi, Stefan

    2015-01-01

    Since the SAMS guidelines on "Borderline questions in intensive-care medicine" were first published in 1999, medicine's capacity to keep patients alive through technological and pharmacological interventions has been substantially enhanced. Public expectations concerning the prospects for successful medical treatment, even in the very elderly, have risen accordingly. In general, however, intensive-care interventions place heavy burdens both on patients and on their relatives and do not always restore health in the manner hoped for. The key question, therefore, is what goals can be attained with intensive care, in what clinical situations. In recent years, this question has been addressed in intensive-care outcomes research. In order to refine the definition of treatment goals, the focus of research has increasingly shifted away from studies of mortality to assess quality of life, long-term outcomes following intensive-care unit (ICU) and hospital discharge, and cost-effectiveness. It has been shown that, in many cases, former ICU patients discharged from hospital show increased mortality and health impairments. At the same time, the majority of surviving patients interviewed after discharge from an ICU say that, should the need arise, they would wish to undergo such treatment again. The practice of intensive-care medicine is influenced not only by medical and social factors but also by legal and political developments. On 1 January 2013, the revised law on the protection of children and adults came into force.1 This strengthens patient self-determination by facilitating personal arrangements for care and regulates the representation of patients who lack capacity in relation to medical decision-making. With the introduction of new financing systems, the application of intensive-care interventions has a major impact not only on a hospital's costs but also on its earnings. Today, intensive-care medicine is confronted with growing tensions between the demands of patients, relatives and referring physicians, ethical questions concerning the appropriateness of certain interventions, and the financial framework set by policymakers, insurers and administrators. In addition, intensive-care medicine is facing staff shortages, which are all the more significant as it is increasingly being called upon to take on responsibilities which are not part of its primary function - for example, caring for patients with no prospect of recovery who cannot be looked after in general wards because of a lack of resources. These additional - non-core - responsibilities increase the pressure on already short-staffed ICUs. If overburdened care team members are unable to work or decide to change jobs, the situation is further exacerbated for those who remain. Given these tensions, there is a need for clearly defined criteria and recommendations for the application of intensive-care interventions. These guidelines2, based on the current state of knowledge, seek to offer specific guidance and to support decision-making in individual cases arising in the day-to-day practice of intensive-care medicine. PMID:25906037

  8. Medical ethics in peace and in the armed conflict.

    PubMed

    Schapowal, Andreas G; Baer, Hans-Ulrich

    2002-08-01

    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

  9. [Clinical drug research from medical ethics and legal perspectives].

    PubMed

    Ornek Büken, Nüket; Büken, Erhan

    2003-01-01

    Medical ethics and law in clinical drug research are the two main points that have been discussed in public and medical circles. Conducting drug research on "easily affected and vulnerable groups", such as psychiatric patients, has always been a controversial issue in medicine. How should human subjects be protected, especially psychiatric patients, who are defined as "vulnerable subjects and groups"; what are the ethically and legally justifiable reasons for basing drug research on psychiatric patients; and what can be said about responsibilities in the context of medical ethics and law? Patients who are in the mentioned groups can not be informed clearly about the characteristics of research which they would be involved in. In recent years psychiatric, geriatric, anesthesiology and pediatric patients are defined as "patients who do not have the ability for consent". In this article answers will be given to questions such as why medical ethics is interested in clinical drug research, and what kind of roles should ethics play in drug research. The situation worldwide will be analyzed from a historical approach with regard to laws and regulations concerning drug research. The legal rights of human subjects who have the ability to give informed consent and of those who do not will be discussed and the place of psychiatric patients as human subjects in drug research will be addressed. Some unethical examples and their consequences will be considered and discussed. In this context, a critical evaluation will be made of the situation in Turkey. PMID:14704931

  10. Annual report of Council, 1985-1986: medical ethics.

    PubMed

    1986-03-29

    Recent activities of the Council of the British Medical Association related to ethical and public policy issues are described. The Council has been working to improve the network of local research ethics committees and favors the establishment of a national committee to review research proposals. It has been engaged in efforts to shape the Data Protection Act to safeguard the confidentiality of personal health records and to protect the confidentiality of minors who seek contraceptive advice without their parents' knowledge. Other Council concerns include advertising by the medical profession and the physician's role in law enforcement in Great Britain and in investigations of torture on the international scene. PMID:11652461

  11. Ethics and animal issues in US medical education.

    PubMed

    Wiebers, D O; Barron, R A; Leaning, J; Ascione, F R

    1994-11-01

    Increasing public and regulatory agency concern about a variety of animal protection issues that affect the field of medicine have made these issues increasingly relevant to medical school curricula. The purpose of this study was to assess the availability and forms of medical school training relating to ethical, conceptual, and societal concerns in the use of animals within the field of medicine and the perceived need for such training. Questionnaire surveys were mailed to the Deans of the 125 accredited US medical schools, and completed by Deans or their designees within the same medical institution. Questionnaire recipients were informed that results would be compiled in a fashion that did not identify specific individuals or institutions. Survey responses were obtained from 84 medical institutions (67% response). Sixty respondents (71%) indicated that their medical school offered or sponsored some type of activity related to ethical and conceptual concerns in the use of animals in medical research and training. Most schools (43) offered informal discussions/seminars relating to these issues, but nine schools offered full formal courses with up to 15 lectures on these topics. Programme content and perceived need for additional instruction varied greatly amongst respondents. The results suggest a wide diversity amongst US medical schools in the availability and perceived importance of medical school training relating to ethical and conceptual concerns in the uses of animals in medicine. It is proposed that instruction in these areas be pursued with more concerted efforts to address the growing body of knowledge about non-human beings and the ethical implications of such knowledge. PMID:7862014

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

    Microsoft Academic Search

    Tore Nilstun; Marina Cuttini; Rodolfo Saracci

    2001-01-01

    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

  13. Dialyser reuse: a study in applied medical ethics.

    PubMed Central

    Kaye, M; Lella, J; Gagnon, R; Mulhearn, B; Low, G

    1985-01-01

    A dialysis unit's introduction of automated recycling of dialysers is described. The responses of the staff and the patients are outlined, along with the pertinent ethical issues. Suggestions regarding the educational processes necessary with any innovation in long-term medical care are discussed. PMID:3971249

  14. Ethics in medicine: Are we blind? In support of teaching medical ethics at the bedside

    Microsoft Academic Search

    John M. Wiecha

    1991-01-01

    The ability to recognize and respond to the ethical dimension of medicine is integral to providing health care that is comprehensive and humane. However, this aspect of medical practice is underemphasized in clinical and academic medicine, despite attempts to devise curricula in this field. This paper examines the origins and consequences of this deficiency through a case history of a

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

    PubMed

    Ludwig, Ariel S; Peters, Roger H

    2014-11-01

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

  16. Drones--ethical considerations and medical implications.

    PubMed

    Pepper, Tom

    2012-01-01

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

  17. The Use of Informational Formats to Implement APA Ethical Principles in Collecting Classroom Data.

    ERIC Educational Resources Information Center

    Dolly, John P.; And Others

    1978-01-01

    Providing more information about experimental studies than required under the ethical principles formulated by the American Psychological Association can result in data bias on a specific task; overall, however, the implementation of ethical principles has little effect on data collected in classroom settings. (RL)

  18. Simulation-based medical education: an ethical imperative.

    PubMed

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

    2003-08-01

    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

  19. Ethics AbAndonEd: Medical Professionalism

    E-print Network

    Blanchette, Robert A.

    chAPtEr 5: Health professional accountability for acts of 135 torture through state licensing Evaluations of 169 Torture and Cruel, Inhuman or Degrading Treatment, Annex 4 2. World Medical Association on 181 Interrogation and Torture 4. Professional Misconduct Complaints Filed 201 notEs 215 Copyright

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

    NASA Astrophysics Data System (ADS)

    Whitehouse, Diane; Duquenoy, Penny

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

  1. Ethical Challenges in Teaching Genetics for Medical Students

    PubMed Central

    Nagle, Erika; Kažoka, Dzintra

    2014-01-01

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

  2. Ethical challenges in teaching genetics for medical students.

    PubMed

    Nagle, Erika; Kažoka, Dzintra

    2014-12-01

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

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

    PubMed

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

    2014-01-01

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

  4. Current Principles and Practice of Ethics and Law in Perinatal Medicine

    PubMed Central

    BERCEANU, C.; ALBU, SIMONA ELENA; BO?, MIHAELA; GHELASE, M.?T.

    2014-01-01

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

  5. Ethical Choice in the Medical Applications of Information Theory

    Microsoft Academic Search

    Scott V. Haig

    2010-01-01

    Background  Alongside advances in medical information technology (IT), there is mounting physician and patient dissatisfaction with present-day\\u000a clinical practice. The effect of introducing increasingly complex medical IT on the ethical dimension of the clinical physician’s\\u000a primary task (identified as direct patient care) can be scrutinized through analysis of the EMR software platform.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore (1) identify IT changes burdensome to the

  6. Medical and ethical dilemma in brain death.

    PubMed

    Streba, Irina; Damian, Simona; Ioan, Beatrice

    2012-01-01

    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

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

    PubMed

    Jotkowitz, Alan

    2013-02-01

    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

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

    PubMed Central

    2014-01-01

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

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

    PubMed

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

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

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

    PubMed Central

    Pray, W. Steven

    2006-01-01

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

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

    PubMed

    Millstone, Michael

    2014-06-01

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

  12. Law and medical ethics in organ transplantation surgery

    PubMed Central

    Woodcock, Tom; Wheeler, Robert

    2010-01-01

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

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

    PubMed

    Dresser, Rebecca

    2006-01-01

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

  14. How not to think: medical ethics as negative education.

    PubMed

    Cigman, Ruth

    2013-02-01

    An implicit rationale for ethics in medical schools is that there is a perceived need to teach students how not to think and how not to act, if they are to avoid a lawsuit or being struck off by the GMC. However, the imperative to keep within the law and professional guidance focuses attention on risks to patients that can land a doctor in trouble, rather than what it means to treat a patient humanely or well. In this paper I explore the gap between learning how not to think and act as a doctor, and learning to be reflective and responsive to patients as fellow human beings. This gap is exposed by the difference between a GMC web resource for doctors, and a detailed ethical discussion by Gawande in his book Complications. The latter raises fundamental questions of meaning, and exemplifies an approach to ethical thinking as the appropriate management of doubt that, according to the argument of this paper, is of utmost importance for doctors. PMID:22477089

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

    PubMed Central

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

    1994-01-01

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

  16. Ethical issues in studying submissions to a medical journal.

    PubMed

    Olson, C M; Glass, R M; Thacker, S B; Stroup, D F

    1998-07-15

    A protocol to prospectively study characteristics of meta-analyses submitted to a weekly medical journal raised several ethical issues. In submitting a manuscript for publication, authors do not implicitly consent to have their work used for research. Authors must be free to refuse to consent, without it affecting their chances for publication. Systematically analyzing data on manuscript characteristics might influence the decision to publish. Having investigators who are not on the editorial staff or peer reviewers extract the manuscripts' characteristics breaks the confidentiality of the author-editor-reviewer relationship. In response to these issues, we added a statement to our journal's instructions for authors that submitted manuscripts may be systematically analyzed to improve the quality of the editorial or peer review process. Authors had to actively consent to participate, but editors and external reviewers were unaware of which authors were participating. The manuscript characteristics were not shared with authors, editors, or external reviewers. The investigators were blinded to each manuscript's author and institution. After we addressed ethical issues encountered in studying manuscripts submitted to a medical journal, 99 of 105 authors submitting a meta-analysis during the study's first 24 months agreed to participate. PMID:9676686

  17. The essential role of medical ethics education in achieving professionalism: the romanell report.

    PubMed

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

    2015-06-01

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

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

    PubMed

    Johnson, Kevin W

    2008-12-01

    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

  19. Laser optoacoustic tomography for medical diagnostics: principles

    NASA Astrophysics Data System (ADS)

    Oraevsky, Alexander A.; Esenaliev, Rinat O.; Jacques, Steven L.; Tittel, Frank K.

    1996-04-01

    This paper is to describe principles of laser optoacoustic tomography for medical diagnostics. Two types of imaging modes are presented. The first is the tomography in transmission mode, which utilizes detection of stress transients transmitted from the laser-excited volume toward the depth through thick layers of tissue. The second is the tomography in reflection mode which utilizes detection of stress transients generated in superficial tissue layer and reflected back toward tissue surface. To distinguish the two modes, we have abbreviated them as (1) laser optoacoustic tomography in transmission mode, LOATT, and (2) time-resolved stress detection tomography of light absorption, TRSDTLA, in reflection mode where emphasis is made on high spatial resolution of images. The basis for laser optoacoustic tomography is the time-resolved detection of laser-induced transient stress waves, selectively generated in absorbing tissues of diagnostic interest. Such a technique allows one to visualize absorbed light distribution in turbid biological tissues irradiated by short laser pulses. Laser optoacoustic tomography can be used for detection of tissue pathological changes that result in either increased concentration of various tissue chromophores such as hemoglobin or in development of enhanced microcirculation in diseased tissue. Potential areas of applications are diagnosis of cancer, brain hemorrhages, arterial atherosclerotic plaques, and other diseased tissues. In addition, it can provide feedback information during medical treatments. Both LOATT and TRSDTLA utilize laser excitation of biological tissues and sensitive detection of laser-induced stress waves. Optical selectivity is based upon differences in optical properties of pathologically different tissues. Sensitivity comes from stress generation under irradiation conditions of temporal stress confinement. The use of sensitive wide-band lithium niobate acoustic transducers expands limits of laser optoacoustic tomography. The technology allows us to determine directly temperature distributions in tissues and locate tissues volumes with different absorption. To demonstrate principles of TRSDTLA, experiments were conducted in vivo with mice-model for breast cancer using specially designed front-surface transducers- reflectometers. To present advantages and limitation of LOATT, experiments were performed in phantoms made of gel with polystyrene spheres colored with copper sulfate. Our experimental results and theoretical calculations show that TRSDTLA can be applied for non- invasive histology of layered tissues with in-depth resolution of up to 2 microns. TRSDTLA in acoustic reflection mode is promising for diagnostics of skin and ocular diseases. LOATT in acoustic transmission mode can be applied for detection of small tissue volumes with enhanced absorption located inside organs at the depth of up to 10 cm.

  20. Bariatric Endocrinology: Principles of Medical Practice

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Kuszler, Patricia C

    2006-09-01

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

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

    PubMed

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

    2015-06-01

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

  3. The gastroenterologist and his endoscope: the embodiment of technology and the necessity for a medical ethics.

    PubMed

    Cooper, M W

    1996-12-01

    The purpose of this essay is to argue for the necessity of an ethics of the practice of the specialist-technologist in medicine. In the first part I sketch three stages of medical ethics, each with a particular viewpoint regarding the technology of medicine. I focus on Brody's consideration of the "physician's power" as a example of contemporary medical ethics which explicitly excludes the specialist-technologist as a locus of development of medical ethics. Next, the philosophy of Heidegger is examined to suggest an approach to the problem, and, finally, some of Levinas' contributions regarding the "other" are introduced to suggest a preliminary approach to a medical ethics of the specialist-technologist. PMID:9001130

  4. The UDHR and The Limits of Medical Ethics: The Case of South Africa.

    PubMed

    Rubenstein; London

    1998-01-01

    The leadership of South Africa's medical profession remained silent in the face of gross human rights violations by the apartheid government or affirmatively defended the government's conduct. While there were strong cultural and economic reasons for this alliance between leaders of the medical profession and the apartheid state, the leadership also embraced western medical ethics. As a result, when confronted about its conduct, it continually sought to defend its behavior on traditional ethical grounds. This article looks at the nature of that "ethical defense" in three areas, torture in detention, racial discrimination in health services, and breach of confidentiality in the case of political activists. The article concludes that the rules of medical ethics left too great a space for making such a defense and urges that ethical rules consistent with the Universal Declaration of Human Rights be adopted. PMID:10343300

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

    PubMed Central

    Ondeck, Michele

    2009-01-01

    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

  6. Developing an ethical framework for short-term international dental and medical activities.

    PubMed

    Friedman, Alexandra; Loh, Lawrence; Evert, Jessica

    2014-01-01

    The popularity of volunteering to provide charity health care in third-world countries has increased dramatically in recent years. While there are advantages to both those being helped and to volunteers, there are also ethical issues that need to be addressed. A framework for analyzing the ethical impact of such service is presented which continues 27 principles that should be addressed. PMID:25080664

  7. Reflecting on senior medical students' ethics reports at the University of Auckland.

    PubMed

    Malpas, Phillipa J

    2011-10-01

    In January 2010, fifth year medical students in the medical programme at the University of Auckland were asked to write a 1200-word report as part of their ethics assessment. The purpose of the report was to get students to reflect critically on the ethical dimension of a clinical case or situation they had been involved in during the past 2 years. Students were required to identify and discuss the salient ethical issues that arose as they saw them, and consider what they had personally learnt from the situation. The purpose of the following discussion is twofold: first, to outline some of the ethical issues raised by year five medical students in their ethics reports; and second, to reflect on what we, as educators and health professionals can learn from their experiences and insights. PMID:21511969

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

    PubMed Central

    Natarajan, A

    1996-01-01

    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 PMID:8630847

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

    PubMed

    Fiester, Autumn M

    2015-06-01

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

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

    PubMed

    Behrmann, Jason

    2010-06-01

    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

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

    PubMed

    Miranda, Alejandro; Contreras, Sebastián

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Simpson, Douglas J.; Sacken, D. Mike

    2015-01-01

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

  13. The influence of environmental practices on ethical attitudes: internal principles vs external factors

    Microsoft Academic Search

    Chieh-Wen Sheng; Ming-Chia Chen

    2010-01-01

    Purpose – This paper aims to examine the influence of individual internal principles and perceived external factors on the ethical attitudes toward environmental practices, on the part of Taiwanese environmental business managers. Design\\/methodology\\/approach – The analysis of 295 pretest samples, moral intensity on environmental issues was divided into “perception of environmental harm” and “perceived immediacy and stress”. Following this, a

  14. Microethics: the ethics of everyday clinical practice.

    PubMed

    Truog, Robert D; Brown, Stephen D; Browning, David; Hundert, Edward M; Rider, Elizabeth A; Bell, Sigall K; Meyer, Elaine C

    2015-01-01

    Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case-based method for teaching ethics, grounding the ethical reasoning in an amalgam of theories drawn from moral philosophy, including consequentialism, deontology, and principlism. In this article we hope to make a case for augmenting the focus of education in medical ethics. We propose complementing the traditional approach to medical ethics with a more embedded approach, one that has been described by others as "microethics," the ethics of everyday clinical practice. PMID:25600383

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

    PubMed Central

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

    2006-01-01

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

  16. Ethical Implications of Psychopharmacotherapy

    Microsoft Academic Search

    Hanfried Helmchen

    \\u000a Both the efficient application of a marketed psychotropic drug to mentally ill persons in practice and the assessment of effectiveness and safety of a potentially therapeutic drug through research imply ethical problems. The basic ethical issue is to find an optimum of the relationship between the benefits and risks\\u000a of a medication with regard to major ethical principles.\\u000a \\u000a \\u000a The therapeutic

  17. Teaching and evaluation methods of medical ethics in the Saudi public medical colleges: cross-sectional questionnaire study

    PubMed Central

    2013-01-01

    Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing. PMID:24020917

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed

    DuBois, James M

    2004-01-01

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

  20. Deep brain stimulation: a principled and pragmatic approach to understanding the ethical and clinical challenges of an evolving technology.

    PubMed

    Racine, Eric; Bell, Emily; Zizzo, Natalie

    2015-01-01

    DBS has emerged in the past few decades as a powerful clinical tool in the treatment of movement disordersMovement disorders such as dystoniaDystonia and Parkinson's diseaseParkinson's disease . As a result of its striking effects, the therapeutic utility of DBS has been investigated in a number of different neurological and neuropsychiatric conditions. Ethical discussion has accompanied this evolution of DBS and has led to the identification of a number of important ethical challenges. In this chapter, we review these challenges based on three of the key principles of biomedical ethicsBiomedical ethics (autonomyAutonomy , justiceJustice , and non-maleficenceNon-maleficence ). Specifically, we adopt a pragmatic perspective by reviewing the ethical issues as they emerge within the context of Parkinson's disease, as this can serve to guide further ethical thinking on the future of DBS. Through this contextualization, we enrich the meaning of the Ethical principleEthical principle s and increase their specificity. We hope that this contribution will inform readers and also stimulate discussion related to areas where important questions remain unanswered and where further research would need to be undertaken to understand and enact ethical principles. PMID:25048390

  1. Informing the gestalt: an ethical framework for allocating scarce federal public health and medical resources to states during disasters.

    PubMed

    Knebel, Ann R; Sharpe, Virginia A; Danis, Marion; Toomey, Lauren M; Knickerbocker, Deborah K

    2014-02-01

    During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters. PMID:24612854

  2. Nutrition research in rural communities: application of ethical principles.

    PubMed

    Faber, Mieke; Kruger, H Salomé

    2013-10-01

    This narrative review focuses on ethics related to nutrition-specific community-based research, within the framework of science for society, and focusing on the rights and well-being of fieldworkers and research participants. In addition to generally accepted conditions of scientific validity, such as adequate sample size, unbiased measurement outcome and suitable study population, research needs to be appropriate and feasible within the local context. Communities' suspicions about research can be overcome through community participation and clear dialogue. Recruitment of fieldworkers and research participants should be transparent and guided by project-specific selection criteria. Fieldworkers need to be adequately trained, their daily schedules and remuneration must be realistic, and their inputs to the study must be recognized. Fieldworkers may be negatively affected emotionally, financially and physically. Benefits to research participants may include physical and psychological benefits, minimal economic benefit, and health education; while risks may be of a physical, psychological, social, or economic nature. Targeting individuals in high-risk groups may result in social stigmatization. The time burden to the research participant can be minimized by careful attention to study procedures and questionnaire design. Potential benefits to the community, fieldworkers and research participants and anticipated knowledge to be gained should outweigh and justify the potential risks. Researchers should have an exit strategy for study participants. For effective dissemination of results to individual research participants, the host community and nutrition community, the language, format and level of presentation need to be appropriate for the target audience. PMID:22591024

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

    PubMed

    Kidd, Ian James

    2012-09-01

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

  4. Dismembering the ethical physician

    PubMed Central

    Genuis, S J

    2006-01-01

    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. PMID:16597808

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

    PubMed Central

    Kluge, Eike-Henner W.

    2007-01-01

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

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

    PubMed

    Mantz, J M; Bastian, B

    1991-11-01

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

  7. Ethics Matter: The Morality and Justice Principles of Elected City Officials and their Impact of Urban Issues

    E-print Network

    Schumaker, Paul; Kelly, Marisa J.

    2012-08-01

    This article pursues the thesis that ethics matter in urban policymaking. Interviews with 95 elected officials in 12 cities revealed the officials' support for—and opposition to—many principles of political morality and political justice. Officials...

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

    PubMed

    Holm, Søren

    2015-01-01

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

  9. [Ethical aspirations and the reality of medical practice at the end of the Ancien Regime].

    PubMed

    Louis-Courvoisier, Micheline

    2012-01-01

    At the end of the 18th century, economic survival was difficult for physicians. The medical market was crowded and to build (and seduce) a clientele, they had to pay particular attention to their appearance. Being well dressed and travelling by horse or in a carriage was necessary to demonstrate that they had a good reputation and were a "good" doctor. However, this still did not guarantee financial security for the doctor and his family. In an era when medical fees were only just beginning to be discussed, it was difficult to know how to bill patients and how to get paid. At the same time, the first texts on medical ethics appeared, insisting on modesty, authenticity, delicacy, and sincerity. In this article, by exploring personal archives and printed moral prescriptions, I will suggest that there were tensions between the everyday difficulties of medical practice and the recommendations on medical ethics, tensions that had consequences for the patient-doctor relationship. PMID:22849249

  10. [New evidence for the author of the medical ethics novel Doctor's Mirror].

    PubMed

    Yang, Fang; Zhu, Hui; Pan, Rong-Hua

    2012-07-01

    Yijiejing (Doctor's Mirror), the first novel focused on medical ethics in the late Qing dynasty, aimed at meliorating medical ethical atmosphere by criticizing disorders among medical practitioners. Some contents of this novel were the same as those in Yijie Xianxingji (Revelation of Medical Community). By comparison between the two books and investigation on Doctor's Mirror's introduction, preface and advertisement in the newspaper at that time, we could find that the author of Doctor's Mirror was not the novelist LU Shi-e, but YU Wen-yao, the author of Yijie Xianxingji. Distribution of Yijie Xianxingji was stopped soon after its publication by the Commercial Press for its allusion to a famous doctor in Shanghai. Two years later, YU made some slight modifications the details of the novel's characters and his book was published with a different title Doctor's Mirror and the pen-name 'medical hermit among scholars'. PMID:23336280

  11. An analytic approach to resolving problems in medical ethics

    Microsoft Academic Search

    D Candee; B Puka

    1984-01-01

    Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The

  12. Mexican geneticists' views of ethical issues in genetics testing and screening. Are eugenic principles involved?

    PubMed

    Lisker, R; Carnevale, A; Armendares, S

    1999-10-01

    Herein we discuss Mexican geneticists' views of ethical issues in genetic testing and screening, analyzing whether eugenic principles are involved in this activity. The information was obtained from a comprehensive survey on genetics, ethics, and society organized by Wertz and Fletcher in 1993, in which 37 nations participated. The responses to 21 questions from 64 out of 89 (72%) geneticists invited to participate are analyzed in this paper. The questions were practically the same as those answered recently by a group of Chinese geneticists (Mao X. Chinese geneticists' views of ethical issues in genetic testing and screening: evidence for eugenics in China. Am J Hum Genet 1998: 63: 688-695), who work in a country where the furtherance of eugenic principles is considered to be the goal of human genetics. We concluded that although there are many similarities in the answers from both countries, this is not indicative of Mexican geneticists pursuing eugenic goals because: a) there is no coercion involved; and b) there is no intention of improving the gene pool. PMID:10636452

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

    PubMed

    Ochasi, Aloysius; Clark, Peter

    2014-04-11

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

  14. Teaching corner: "first do no harm": teaching global health ethics to medical trainees through experiential learning.

    PubMed

    Logar, Tea; Le, Phuoc; Harrison, James D; Glass, Marcia

    2015-03-01

    Recent studies show that returning global health trainees often report having felt inadequately prepared to deal with ethical dilemmas they encountered during outreach clinical work. While global health training guidelines emphasize the importance of developing ethical and cultural competencies before embarking on fieldwork, their practical implementation is often lacking and consists mainly of recommendations regarding professional behavior and discussions of case studies. Evidence suggests that one of the most effective ways to teach certain skills in global health, including ethical and cultural competencies, is through service learning. This approach combines community service with experiential learning. Unfortunately, this approach to global health ethics training is often unattainable due to a lack of supervision and resources available at host locations. This often means that trainees enter global health initiatives unprepared to deal with ethical dilemmas, which has the potential for adverse consequences for patients and host institutions, thus contributing to growing concerns about exploitation and "medical tourism." From an educational perspective, exposure alone to such ethical dilemmas does not contribute to learning, due to lack of proper guidance. We propose that the tension between the benefits of service learning on the one hand and the respect for patients' rights and well-being on the other could be resolved by the application of a simulation-based approach to global health ethics education. PMID:25648122

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

    PubMed Central

    Faria, Miguel A.

    2015-01-01

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

  16. [Medical ethical aspects of culture in social interactions with Muslim patients].

    PubMed

    Ilkilic, I

    2007-07-30

    In today's world, the plurality of values is considered to be a constitutive feature of modern societies. In these societies, transcultural patient-physician relationships are a part of daily medical practice. Culturally determined value systems can be crucial for understanding the perception of notions such as "health" and "illness", leading to fundamental differences in assessing medical interventions and therapeutic objectives. Therefore, transcultural conflicts of interest are presenting medical ethical decision-making with new challenges. Time and again, medical practice demonstrates that cultural differences between physician and patient are correlated with the complexity of medical ethical conflicts, as can be seen in the relationship between Muslim patients and non-Muslim physicians in the German health care system. This paper discusses some of the central issues in these relationships like communication, sense of shame, religious duties, and medical end-of-life decisions, analyzing some concrete cases. Subsequently, a number of medical ethical theses relevant for multicultural societies will be discussed. PMID:17628845

  17. Ethical and methodological standards for laboratory and medical biological rhythm research.

    PubMed

    Portaluppi, Francesco; Touitou, Yvan; Smolensky, Michael H

    2008-11-01

    The main objectives of this article are to update the ethical standards for the conduct of human and animal biological rhythm research and recommend essential elements for quality chronobiological research information, which should be especially useful for new investigators of the rhythms of life. A secondary objective is to provide for those with an interest in the results of chronobiology investigations, but who might be unfamiliar with the field, an introduction to the basic methods and standards of biological rhythm research and time series data analysis. The journal and its editors endorse compliance of all investigators to the principles of the Declaration of Helsinki of the World Medical Association, which relate to the conduct of ethical research on human beings, and the Guide for the Care and Use of Laboratory Animals of the Institute for Laboratory Animal Research of the National Research Council, which relate to the conduct of ethical research on laboratory and other animals. The editors and the readers of the journal expect the authors of submitted manuscripts to have adhered to the ethical standards dictated by local, national, and international laws and regulations in the conduct of investigations and to be unbiased and accurate in reporting never-before-published research findings. Authors of scientific papers are required to disclose all potential conflicts of interest, particularly when the research is funded in part or in full by the medical and pharmaceutical industry, when the authors are stock-holders of the company that manufactures or markets the products under study, or when the authors are a recent or current paid consultant to the involved company. It is the responsibility of the authors of submitted manuscripts to clearly present sufficient detail about the synchronizer schedule of the studied subjects (i.e., the sleep-wake schedule, ambient light-dark cycle, intensity and spectrum of ambient light exposure, seasons when the research was conducted, shift schedule in studies involving shift work, and menstrual cycle stage in studies involving young women). Rhythm analysis of time series data should be performed with the perspective that rhythms of different periods might be superimposed upon the observed temporal pattern of interest. A variety of different and complementary statistical procedures can be used for rhythm detection. Fitting a mathematical model to the time series data provides a better and more objective analysis of time series data than simple data inspection and narrative description, and if rhythmicity is documented by objective methods, its characterization is required by relevant parameters such as the rhythm's period (tau), MESOR (time series average), amplitude (range of temporal variation), acrophase (time of peak value), and bathyphase (time of trough value). However, the assumptions underlying the time series modeling must be satisfied and applicable in each case, especially the assumption of sinusoidality in the case of cosinor analysis, before it can be accepted as appropriate. An important aspect of the peer review of manuscripts submitted to Chronobiology International entails judgment of the conformity of research protocols and methods to the standards described in this article. PMID:19005901

  18. Justice and care: the implications of the Kohlberg-Gilligan debate for medical ethics.

    PubMed

    Sharpe, V A

    1992-12-01

    Carol Gilligan has identified two orientations to moral understanding; the dominant 'justice orientation' and the under-valued 'care orientation'. Based on her discernment of a 'voice of care', Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others. PMID:1492344

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

    PubMed Central

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

    2012-01-01

    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. PMID:22403593

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

    PubMed

    McCullough, Laurence B

    1999-03-01

    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

  1. Subject, project or self? Thoughts on ethical dilemmas for social and medical researchers

    Microsoft Academic Search

    Jane A. Batchelor; Catherine M. Briggs

    1994-01-01

    In this paper we address an important but sadly neglected area; namely some of the ethical issues which arise for social and medical researchers in the course of their work. Our concern is for a wide spectrum of researchers using the full range of social research methods from small-scale in-depth qualitative work through to large scale quantitative studies. The unifying

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

    PubMed Central

    Becker, Daniel E

    2009-01-01

    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. PMID:19769423

  3. 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

    Microsoft Academic Search

    J Tobin

    2005-01-01

    Medical Officers serving with their national contingents in peacekeeping operations are faced with difficult ethical decisions in regard to their obligations to the local civilian population. Such populations may be under-resourced in regard to medical care, and vulnerable to abuse and exploitation. Though the medical officer may support the local medical services, he\\/she should never undermine these resources. Adopting a

  4. Living donation and cosmetic surgery: a double standard in medical ethics?

    PubMed

    Testa, Giuliano; Carlisle, Erica; Simmerling, Mary; Angelos, Peter

    2012-01-01

    The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation. PMID:22822698

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

    PubMed Central

    Weindling, P.

    1996-01-01

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

  6. Ethical conduct of humanitarian medical missions: I. Informed Consent.

    PubMed

    Holt, G Richard

    2012-01-01

    Altruistic and socially conscious physicians are dedicating a portion of their professional lives to humanitarian relief of disadvantaged populations in increasing numbers. These efforts are primarily carried out through short-term medical missions(STMMs) throughout the international community.(1) There is a great deal of professional and personal reward to physicians who participate in medical missions, and their experiences as related to colleagues may serve to encourage others to participate as well. Indeed, there is an increasing interest in, and enthusiasm for, medical students to participate in international volunteer electives during medical school, particularly in developing countries. Their positive experiences often shape their future commitment to volunteerism as a physician.(2) PMID:22596265

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

    Microsoft Academic Search

    Marcel J. H. Kenter

    2009-01-01

    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

  8. [Scientometrics and publishing in Hungarian medical science. Ethical and technical issues].

    PubMed

    Fazekas, T; Varró, V

    2001-11-11

    The authors present an account of the main ethical and technical aspects relating to the measurement of medical publication activities and the compilation of publications lists. It is demonstrated that the Anglo-American scientometric system (Institute for Scientific Information, USA) is currently gaining stable ground in Hungary. At the same time, however, there continues to be a place for a national publication index used to assess Hungarian-language publication activity, for the two systems conveniently supplement one another. The criterion system of medical publishing established by the International Committee of Medical Journal Editors (ICMJE) is described in detail, and is recommended for wide-ranging application in Hungary. PMID:11778357

  9. [Ethical principles and approaches to health systems governance research: conceptual and methodological implications].

    PubMed

    Flores, Walter

    2010-01-01

    Governance refers to decision-making processes in which power relationships and actors and institutions' particular interests converge. Situations of consensus and conflict are inherent to such processes. Furthermore, decision-making happens within a framework of ethical principles, motivations and incentives which could be explicit or implicit. Health systems in most Latin-American and Caribbean countries take the principles of equity, solidarity, social participation and the right to health as their guiding principles; such principles must thus rule governance processes. However, this is not always the case and this is where the importance of investigating governance in health systems lies. Making advances in investigating governance involves conceptual and methodological implications. Clarifying and integrating normative and analytical approaches is relevant at conceptual level as both are necessary for an approach seeking to investigate and understand social phenomena's complexity. In relation to methodological level, there is a need to expand the range of variables, sources of information and indicators for studying decision-making aimed to greater equity, health citizenship and public policy efficiency. PMID:20963300

  10. Paradigms and personhood: a deepening of the dilemmas in ethics and medical ethics.

    PubMed

    Erde, E L

    1999-04-01

    There are many calls for a definition of personhood, but also many logical and Wittgensteinian reasons to think fulfilling this is unimportant or impossible. I argue that we can consider many contexts as language-games and consider the person as the key player in each. We can then examine the attributes, presuppositions and implications of personhood in those contexts. I use law and therapeutic psychology as two examples of such contexts or language-games. Each correlates with one of the classic "theories" of ethics-deontology and consequentialism. But each is a large enough cluster to consider them as paradigms in a sense related to Thomas Kuhn's notion in The Structure of Scientific Revolutions. Showing the presuppositions about and "takes" on personhood together with the connections involved in the paradigms deepens the dilemmas we already know to be present. PMID:10450664

  11. [The growing importance of ethics in medical care and research].

    PubMed

    Sass, Hans-Martin

    2009-01-01

    The integration of medical humanities into future patient care and medical research will become as importance for trust, care and health as the natural sciences were during the last 100 years. In particular, improvements of lay health literacy and responsibility, new forms of physician-nurse partnership and expert-lay interaction, also revisions of clinical research towards models of informed contract will improve trust and health on a global scale, allow for healthier and happier citizens and populations and eventually might reduce health care costs. PMID:19823790

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  13. Medical ethics in France: The latest great political debate

    Microsoft Academic Search

    Anne Marie Moulin

    1988-01-01

    The American term Bioethics has been adopted over the last ten years and the development of Bioethics committees on the American model testifies this influence, even before the official appointment of a National Committee in 1983. This phenomenon acknowledged as the “emergence of French bioethics” is in fact the final outcome of a long-lasting crisis in the medical profession, in

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

    PubMed

    Ghaly, Mohammed

    2014-02-01

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

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

    PubMed Central

    2010-01-01

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

  16. Combining interdisciplinary and International Medical Graduate perspectives to teach clinical and ethical communication using multimedia.

    PubMed

    Woodward-Kron, Robyn; Flynn, Eleanor; Delany, Clare

    2011-01-01

    In Australia, international medical graduates (IMGs) play a crucial role in addressing workforce shortages in healthcare. Their ability to deliver safe and effective healthcare in an unfamiliar cultural setting is intrinsically tied to effective communication. Hospital-based medical clinical educators, who play an important role in providing communication training to IMGs, would benefit from practical resources and an understanding of the relevant pedagogies to address these issues in their teaching. This paper examines the nature of an interdisciplinary collaboration to develop multimedia resources for teaching clinical and ethical communication to IMGs. We describe the processes and dynamics of the collaboration, and outline the methodologies from applied linguistics, medical education, and health ethics that we drew upon. The multimedia consist of three video clips of challenging communication scenarios as well as experienced IMGs talking about communication and ethics. The multimedia are supported by teaching guidelines that address relevant disciplinary concerns of the three areas of collaboration. In the paper's discussion we point out the pre-conditions that facilitated the interdisciplinary collaboration. We propose that such collaborative approaches between the disciplines and participants can provide new perspectives to address the multifaceted challenges of clinical teaching and practice. PMID:22616355

  17. [A world of difference: an ethical analysis of medical missions to developing countries].

    PubMed

    Olthuis, Gert; Rol, Marjolein L; de Blaauw, Ivo

    2014-01-01

    This article concerns an ethical analysis of medical missions to developing countries. Our starting point is a case study. The concept of 'responsibility' plays a key role in the analysis. Responsibility for the results and responsibility for recovery can be reviewed on a personal level, as well as on a national and global level. In order to reduce the differences in healthcare between developed and less developed countries, responsibility will have to be taken on a national and global level, so that the help provided might last. Until then, healthcare providers will have to decide whether to participate in medical missions, expressing their personal responsibility in that way. PMID:25492731

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

    PubMed Central

    2010-01-01

    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. PMID:20438627

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

    PubMed

    Paul, N W; Mitzkat, A

    2013-11-01

    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

  20. Teaching medical ethics: problem-based learning or small group discussion?

    PubMed Central

    Heidari, Akram; Adeli, Seyyed-Hassan; Taziki, Sadegh-Ali; Akbari, Valliollahe; Ghadir, Mohammad-Reza; Moosavi-Movahhed, Seyyed-Majid; Ahangari, Roghayyeh; Sadeghi-Moghaddam, Parvaneh; Mirzaee, Mohammad-Rahim; Damanpak-Moghaddam, Vahid

    2013-01-01

    Lecture is the most common teaching method used in ethics education, while problem-based learning (PBL) and small group discussion (SGD) have been introduced as more useful methods. This study compared these methods in teaching medical ethics. Twenty students (12 female and 8 male) were randomly assigned into two groups. The PBL method was used in one group, and the other group was taught using the SGD method. Twenty-five open-ended questions were used for assessment and at the end of the course, a course evaluation sheet was used to obtain the students’ views about the advantages and disadvantages of each teaching method, their level of satisfaction with the course, their interest in attending the sessions, and their opinions regarding the effect of teaching ethics on students’ behaviors. The mean score in the PBL group (16.04 ± 1.84) was higher than the SGD group (15.48 ± 2.01). The satisfaction rates in the two groups were 3.00 ± 0.47 and 2.78 ± 0.83 respectively. These differences were not statistically significant. Since the mean score and satisfaction rate in the PBL group were higher than the SGD group, the PBL method is recommended for ethics education whenever possible. PMID:23908762

  1. Unforeseen ethical/legal complications with screening tests in the capitation model of medical aid schemes.

    PubMed

    Jansen, Rita-Marie; Gouws, Chris; Verschoor, Teuns

    2012-10-01

    In the South African health care system patients/consumers are divided into those who can afford private care and those who rely on state medical assistance. The system is under pressure to fund delivery of medical care to its beneficiaries. We consider the effects of different funding models on medicolegal liability of health professionals serving the private sector. Medical reasons should determine the service rendered. However, financial implications of services rendered and defensive practice of medicine also contribute to treatment received by a patient and its remuneration. Practitioners who commit to delivering a predetermined set of services within a particular time for a predetermined 'lump sum' are only paid for the service specifically requested. Should disease be found other than those contracted for, we argue that inaction with regard to that disease would be deemed to be negligent or unethical according to legal and ethical considerations. PMID:23034204

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Dargahi, Hossein

    2011-01-01

    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

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

    ERIC Educational Resources Information Center

    O'Neill, John

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

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

    2014-09-01

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

  7. Secret remedies, medical ethics, and the finances of the British Medical Journal

    Microsoft Academic Search

    Peter Bartrip

    This essay explores three themes relating to the use of patent or proprietary medicines, the so-called “secret remedies,”\\u000a in the Victorian and Edwardian periods. First, quackery in nineteenth-century Britain and in particular the attitudes of the\\u000a Provincial Medical and Surgical Association (British Medical Association, or “BMA”, from 1856) towards it. Second, the economics\\u000a of the British Medical Journal (BMJ) and

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

    PubMed

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

    2007-01-01

    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

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

    PubMed

    Fan, Ruiping

    2006-01-01

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

  10. [Social consensus on medical technology policy: ethical issues and citizen participation].

    PubMed

    Sato, Hajime

    2004-01-01

    Social consensus is considered to be a necessary condition for a policy to be introduced and implemented effectively. This is the case with the approval, regulation and prohibition of certain advanced medical research and technology, especially when they could invoke moral disputes in society. Public policies on organ transplantation, definition of death, euthanasia, genetic screening and diagnosis, and human stem cell research are recent examples. The concept of consensus, however, is elusive, along with the measures to secure it. Technocratic decision making, as a paternalistic activity frequently led by experts, sometimes poses a challenge to democratic decision making, supposedly based on a well-informed and rational public. It also remains to be proved whether public involvement in policymaking can be a solution to ethical value conflicts in society. From the perspective of policy sciences, this paper first introduces the concept of consensus, especially consensus on moral issues in pluralistic societies, and its implications to public policy, including citizen participation in decision making. Then, it briefly explains the historical background with which social consensus and public involvement have increasingly flourished in the field of technology assessments and technology policy making, including biomedical technology. Next, major institutions, governmental and nongovernmental, involved in the ethical aspects of medical research and technology, are presented along with their efforts for citizen participation. Finally, the paper discusses some of the future agendas on this issue. PMID:15007900

  11. The development of joint principles: integrating behavioral health care into the patient-centered medical home.

    PubMed

    2014-06-01

    This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH. PMID:24955690

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

    PubMed Central

    Tobin, J

    2005-01-01

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

  13. Ethical Dilemmas in Disaster Medicine

    PubMed Central

    Ozge Karadag, C; Kerim Hakan, A

    2012-01-01

    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. PMID:23285411

  14. [The input of medical community into development of fundamental principles of Zemstvo medicine of Russia].

    PubMed

    Yegorysheva, I V

    2013-01-01

    The article considers the participation of medical community in formation of fundamental principles of unique system of public health--the Zemstvo medicine. This occurrence found its reflexion in activities of medical scientific societies and congresses, periodic medical mass media. PMID:24649614

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

    PubMed Central

    Donohoe, Martin

    2004-01-01

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

  16. Ethical and legal issues in palliative care.

    PubMed

    Bernat, J L

    2001-11-01

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

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

    PubMed

    Wall, L L

    2006-06-01

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

  18. Including a Spiritual Dimension in Family Therapy: Ethical Considerations

    Microsoft Academic Search

    Ingeborg E. Haug

    1998-01-01

    The inclusion of a spiritual dimension in family therapy theory and clinical practice may well be viewed as an important professional challenge of the nineties. Following a working definition of terms, this paper explores the ethical complexities inherent in operationalizing a spiritual orientation in therapy in light of the following principles adopted from medical ethics: Respect for clients' autonomy, safeguarding

  19. Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

    PubMed Central

    Frati, Paola; Montanari Vergallo, Gianluca; Di Luca, Natale Mario; Turillazzi, Emanuela

    2014-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

    Czeisler, Charles A.

    2009-01-01

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

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

    PubMed

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

    2015-02-01

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

  3. THE MEDICAL COLLEGE OF WISCONSIN MEDICAL SCHOOL ACADEMIC BULLETIN 20112012 3 The Medical College of Wisconsin is dedicated to the education and

    E-print Network

    THE MEDICAL COLLEGE OF WISCONSIN MEDICAL SCHOOL ACADEMIC BULLETIN 2011­2012 3 Welcome T The Medical of medicine and the highest professional and ethical principles. The Medical College of Wisconsin integrates affiliates-- Children's Hospital of Wisconsin, Froedtert Hospital, and the Zablocki Veterans Affairs Medical

  4. Access to Medical Records.

    ERIC Educational Resources Information Center

    Cooper, Nancy

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

  5. Medical oncology: Basic principles and clinical management of cancer

    SciTech Connect

    Calabresi, P.; Schein, P.S.; Rosenberg, S.A.

    1985-01-01

    This book consists of three section, each containing several papers. The sections are: Basic Principles, Specific Neoplasmas, and Supportive Care. Some of the paper titles are: Pharmacology of Antineoplastic Agents, Hodgkin's Disease, Myeloma, Melanoma, Neoplasms of the Lung, Sarcomas, Pediatric Neoplasms, Infectious Consideration in Cancer, Nursing Considerations in Cancer, and Rehabilitation of the Patient with Cancer.

  6. School Psychology: How Universal are Ethical Principles Approved by International Associations&quest

    Microsoft Academic Search

    Jean L. Pettifor

    2004-01-01

    Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics arid competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise. Challenges exist in accommodating values related to the individualism, democracy, secularism, science,

  7. "Is This Ethical?" A Survey of Opinion on Principles and Practices of Document Design.

    ERIC Educational Resources Information Center

    Dragga, Sam

    1996-01-01

    Reprints a corrected version of an article originally published in the volume 43, number 1 issue of this journal. Presents results of a national survey of technical communicators and technical communication teachers assessing the ethics of seven document design cases involving manipulation of typography, illustrations, and photographs. Offers…

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

    ERIC Educational Resources Information Center

    Pettifor, Jean L.

    2004-01-01

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

  9. The Bucharest Declaration Concerning Ethical Values and Principles for Higher Education in the Europe Region

    ERIC Educational Resources Information Center

    Higher Education in Europe, 2004

    2004-01-01

    UNESCO-CEPES is called to disseminate and implement--in collaboration with other relevant partners--the present Declaration. In order to achieve the ethical vocation of higher education institutions in line with the highly praised values of academic ethos, UNESCO's European Centre for Higher Education convened the International Conference on…

  10. The inadequacy of role models for educating medical students in ethics with some reflections on virtue theory.

    PubMed

    Erde, E L

    1997-01-01

    Persons concerned with medical education sometimes argued that medical students need no formal education in ethics. They contended that if admissions were restricted to persons of good character and those students were exposed to good role models, the ethics of medicine would take care of itself. However, no one seems to give much philosophic attention to the ideas of model or role model. In this essay, I undertake such an analysis and add an analysis of role. I show the weakness in relying on role models exclusively and draw implications from these for appeals to virtue theory. Furthermore, I indicate some of the problems about how virtue theory is invoked as the ethical theory that would most closely be associated to the role model rhetoric and consider some of the problems with virtue theory. Although Socrates was interested in the character of the (young) persons with whom he spoke, Socratic education is much more than what role modeling and virtue theory endorse. It-that is, philosophy-is invaluable for ethics education. PMID:9129391

  11. Teaching evidence-based medicine to undergraduate medical students: a course integrating ethics, audit, management and clinical epidemiology.

    PubMed

    Rhodes, Martin; Ashcroft, Richard; Atun, Rifat A; Freeman, George K; Jamrozik, Konrad

    2006-06-01

    A six-week full time course for third-year undergraduate medical students at Imperial College uniquely links evidence-based medicine (EBM) with ethics and the management of change in health services. It is mounted jointly by the Medical and Business Schools and features an experiential approach. Small teams of students use a problem-based strategy to address practical issues identified from a range of clinical placements in primary and secondary care settings. The majority of these junior clinical students achieve important objectives for learning about teamwork, critical appraisal, applied ethics and health care organisations. Their work often influences the care received by patients in the host clinical units. We discuss the strengths of the course in relation to other accounts of programmes in EBM. We give examples of recurring experiences from successive cohorts and discuss assessment issues and how our multi-phasic evaluation informs evolution of the course and the potential for future developments. PMID:16807168

  12. Introduction of contextual legal issues in an interdisciplinary program for the study of ethical dilemmas in obstetrics and gynecology for third-year medical students

    Microsoft Academic Search

    Victoria L. Green; Danielle Sara

    2002-01-01

    Objective: To introduce contextual legal issues, and the role of law in resolving ethical dilemmas, in a women's health ethics curriculum for third-year medical students. Methods: Seventeen third-year medical students at Emory University School of Medicine, rotating on an 8-week obstetrics and gynecology clerkship, and 8 third-year law students from the Georgia State University College of Law attended four 1-hour

  13. Medical profession changes between religion, science, skill, ethics, law and economics.

    PubMed

    Angeletti, L R

    1997-01-01

    How has the medical profession changed during the centuries? How has the evolution of the profession been influenced by the balance of different issues, e.g. magic, religion, philosophy, science, technology, ethics, law and/or economics? One needs to examine many historical changes leading from the hierarchized medicine of Ancient Egypt to the Asklepiadic and Hippocratic medicine at the time of Plato, from the newly organized medicine of the Renaissance to the emerging social medicine of the XIX century, from the nosological medicine centered on the evaluation of the symptoms to the medicine which explores the human body through technologies. Furthermore, an overview from the past to the future should analyze the new doctor-patient relationship in a health system of managed care, between market and solidarity, between the efficientistic guidelines of the providers (hospitals, physicians, etc.) and an anthropocentric view of the rights of the citizen-customers. These problems are presented and discussed by many Authors in three issues of Medicina nei Secoli (II/III.1997-I, 1998) as an aid to understanding what it means to be a physician today, from the past to the future. PMID:11619955

  14. Principled moral reasoning: Is it a viable approach to promote ethical integrity?

    Microsoft Academic Search

    James Weber; Sharon Green

    1991-01-01

    In response to recent recommendations for the teaching of principled moral reasoning in business school curricula, this paper assesses the viability of such an approach. The results indicate that, while business students' level of moral reasoning in this sample are like most 18- to 21-year-olds, they may be incapable of grasping the concepts embodied in principled moral reasoning. Implications of

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

    PubMed Central

    Vasserman, Eugene Y.; Hatcliff, John

    2014-01-01

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

  16. Ethics committees.

    PubMed

    Sacchini, D; Pennacchini, M

    2010-01-01

    Ethics committees (ECs) are a relevant body for dealing with ethical issues in healthcare. They born in order to resolve dilemmatic situations. Contemporary ECs are independent standing committees with multidisciplinary representation, including medicine, nursing, social work, law, pastoral care, healthcare administration, and other different expertises. The functions of ECs are various: estimating clinical trials; analyzing ethically relevant clinical cases; drafting hospital/organizational guidelines, and to carry out education activity. The composition and kind of skills requested in an EC could change according to national laws. About international ethical standards in clinical experimentation, the World Medical Association's Declaration of Helsinki is the reference according to which examining clinical trials by ECs. PMID:20589364

  17. Is the non-respect of ethical principles by doctors during Down's syndrome screening by first-trimester ultrasound damaging to

    E-print Network

    Boyer, Edmond

    Is the non-respect of ethical principles by doctors during Down's syndrome screening by first Biomédicale (IIREB). Key words: Prenatal diagnosis, Down syndrome, nuchal translucency, informed consent population know about Down's syndrome screening by nuchal translucency?, what is the personal position

  18. A cross-sectional survey to investigate community understanding of medical research ethics committees.

    PubMed

    Fritschi, Lin; Kelsall, Helen L; Loff, Bebe; Slegers, Claudia; Zion, Deborah; Glass, Deborah C

    2015-07-01

    Study explanatory forms often state that an ethics committee has approved a research project. To determine whether the lay community understand the roles of ethics committees in research, we took a cross-sectional national sample from three sampling frames: the general population (n=1532); cohort study participants (n=397); and case-control study participants (n=151). About half (51.3%) of the participants had heard of ethics committees. Those who had were more likely to be those who had participated in previous surveys, older participants, those born in Australia and those with higher education. Almost all participants agreed that the roles of an ethics committee were to protect participants' privacy and ensure no harm came to study participants and most agreed that the committee's role was to ensure that the research was capable of providing answers. Case-control and cohort participants were more likely than the general population to consider that the role of an ethics committee was to design the research and obtain research funding. Overall, we found that about half of the population are aware of ethics committees and that most could correctly identify that ethics committees are there to protect the welfare and rights of research participants, although a substantial minority had some incorrect beliefs about the committees' roles. Increased education, particularly for migrants and older people, might improve understanding of the role of ethics committees in research. PMID:25605609

  19. Conversations about challenging end-of-life cases: ethics debriefing in the medical surgical intensive care unit.

    PubMed

    Santiago, Cecilia; Abdool, Steve

    2011-01-01

    Clinicians frequently encounter and grapple with complex ethical issues and perplexing moral dilemmas in critical care settings. Intensive care unit (ICU) clinicians often experience moral distress in situations in which the ethically right course of action is intuitively known, but cannot be acted on. Most challenging cases pertain to end-of-life issues. Researchers have shown that moral distress and moral residue are common among critical care nurses. It is, therefore, essential that all ICU clinicians (and nurses, in particular) have an ongoing opportunity to work safely through these ethical dilemmas and conflicts. In this article, we describe the medical surgical intensive care unit (MSICU) experience with its monthly ethics initiative and explore the next steps to enhance its use through maximizing attendance and value to MSICU clinicians. To optimize attendance of staff a small group discussion among critical care clinicians (n = 8) was conducted asking about their perceptions of the debriefing sessions and their suggestions on how to promote their use. Process changes were implemented based on the group's suggestions. The process changes resulted in increased awareness of the benefits, increased frequency of sessions and demonstrated utility. Lessons learned from the MSICU experience will inform the development of education curricula to help critical care nurses with challenging end-of-life situations. PMID:22279847

  20. Ethics in clinical research: the Indian perspective.

    PubMed

    Sanmukhani, J; Tripathi, C B

    2011-03-01

    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

  1. The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia

    PubMed Central

    Alkabba, Abdulaziz F.; Hussein, Ghaiath M. A.; Albar, Adnan A.; Bahnassy, Ahmad A.; Qadi, Mahdi

    2012-01-01

    Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: “What top ten ethical challenges are Saudis likely to face in health care?” The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts’ meeting. Results: The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1) Patients’ Rights, (2) Equity of resources, (3) Confidentiality of the patients, (4) Patient Safety, (5) Conflict of Interests, (6) Ethics of privatization, (7) Informed Consent, (8) Dealing with the opposite sex, (9) Beginning and end of life, and (10) Healthcare team ethics. Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges. PMID:22518351

  2. Statement of Principles and Strategies for the Equitable Dissemination of Medical Technologies

    E-print Network

    Statement of Principles and Strategies for the Equitable Dissemination of Medical Technologies-related inventions of academic researchers by developing and disseminating these technologies for the public good. We risk takers to invest in our early stage technology in the hope of possible downstream commercial

  3. Texas A&M Veterinary Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship, and Creative Work

    E-print Network

    Texas A&M Veterinary Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship, and Creative Work Approved: February 8, 2013 Next Scheduled Review: February 8, 2015 Texas A&M Veterinary RULE STATEMENT Texas A&M Veterinary Medical Diagnostic Laboratory (TVMDL) strives to maintain superior

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

    PubMed

    Jotkowitz, Alan; Zivotofsky, Ari Z

    2010-01-01

    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

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

    PubMed Central

    Schochow, Maximilian; Steger, Florian

    2015-01-01

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

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

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Boyle, Philip

    1989-01-01

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

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

    PubMed

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

    2013-09-01

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

  9. 77 FR 2556 - Ethical and Regulatory Challenges in the Development of Pediatric Medical Countermeasures; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ...Regulatory Challenges in the Development of Pediatric Medical Countermeasures; Public Workshop...Drug Administration (FDA), Office of Pediatric Therapeutics, is announcing a public...Regulatory Challenges in the Development of Pediatric Medical Countermeasures.'' There...

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

    Microsoft Academic Search

    Deborah Bowman

    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

  11. Health research ethics review and needs of institutional ethics committees in Tanzania.

    PubMed

    Ikingura, J K B; Kruger, M; Zeleke, W

    2007-09-01

    This study was undertaken to describe the performance of health research ethics review procedures of six research centres in Tanzania. Data collection was done through a self-administered questionnaire and personal interviews. The results showed that there were on average 11 members (range = 8-14) in each Research Ethic Committee. However, female representation in the committees was low (15.2%). The largest proportion of the committee members was biomedical scientists (51.5%). Others included medical doctors (19.7%), social scientists (7.6%), laboratory technologists (10.6%), religious leaders (4.5%), statisticians (3.0%), teachers (1.5%) and lawyers (1.5). Committee members had different capacities to carry out review of research proposals (no capacity = 2%; limited capacity = 15%; moderate capacity = 20%; good capacity = 48%, excellent capacity = 13%). Only half of the respondents had prior ethics review training. Although the majority deemed that ethical guidelines were very important (66%), there were challenges in the use of ethical guidelines which included lack of awareness on the national accreditation mechanisms for ethics committee (59%). Adherence to ethical principles and regulations was influenced by being a scientist (OR = 42.47), being an employee of a professional organization (OR = 15.25), and having an interests in the use of ethical guidelines (OR = 10.85) These findings indicate the need for capacity strengthening (through training and resource support), inclusion of more female representation and other mandatory professions to the research ethics committees. PMID:18087891

  12. Ethics committees and achievement of good clinical practice.

    PubMed

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

    1996-01-01

    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

  13. The use of personal data from medical records and biological materials: ethical perspectives and the basis for legal restrictions in health research

    Microsoft Academic Search

    Enrique Regidor

    2004-01-01

    This paper discusses the moral justification for using personal data without informed consent, from both medical records and biological materials, in research where subjects are not physically present in the study and will never have any contact with the study investigators. Although the idea of waiving the requirement for informed consent in certain investigations has been mentioned in several ethical

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

    Microsoft Academic Search

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

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of

  15. Ethical Tensions in the Pain Management of an End-Stage Cancer Patient with Evidence of Opioid Medication Diversion.

    PubMed

    Venkat, Arvind; Kim, David

    2014-11-01

    At the end of life, pain management is commonly a fundamental part of the treatment plan for patients where curative measures are no longer possible. However, the increased recognition of opioid diversion for secondary gain coupled with efforts to treat patients in the home environment towards the end of life creates the potential for ethical dilemmas in the palliative care management of terminal patients in need of continuous pain management. We present the case of an end-stage patient with rectal cancer who required a continuous residential narcotic infusion of fentanyl for pain control due to metastatic disease. His functional status was such that he had poor oral intake and ability to perform other activities of daily living, but was able to live at home with health agency nursing care. The patient presented to this institution with a highly suspect history of having lost his fentanyl infusion in a residential accident and asking for a refill to continue home therapy. The treating physicians had concerns of diversion of the infusion medication by caregivers and were reluctant to continue the therapeutic relationship with the patient. This case exemplifies the tension that can exist between wanting to continue with palliative care management of an end-stage patient and the fear of providers when confronted by evidence of potential diversion of opioid analgesic medications. We elucidate how an ethical framework based on a combination of virtue and narrative/relationship theories with reference to proportionality can guide physicians to a pragmatic resolution of these difficult situations. PMID:25381648

  16. [Medical progress, ethics, and euthanasia: the case of neonatal intensive care].

    PubMed

    Cuttini, M

    2001-02-01

    Failing to define what is meant by euthanasia often complicates the ethical debate, and exacerbates the conflict between supporters of different views. The scientific and technological progress of modern medicine may lead to difficult dilemmas when available treatment can only prolong the process of dying, or achieve survival at the expenses of severe residual disability. As an example, the case of neonatal intensive care is discussed on the basis of the results provided by an international research project (EURONIC) aimed at investigating end-of-life decision-making in several European countries. PMID:11294112

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

    PubMed

    Green, Alexa

    2010-01-01

    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

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

    PubMed

    Arnold, Denis G; Oakley, James L

    2013-06-01

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

  19. [The modern approaches to the principles of medical and surgical casualty estimation. The US and British experience].

    PubMed

    Zhuravlev, V K; Golota, A S; Krassi?, A B; Mironov, V G; Parfenov, V D

    2014-01-01

    The current article is dedicated to the principles of medical and surgical casualty estimation elaborated by the medical services of the US and Great Britain Armed Forces on the basis of their experience obtained during Afghanistan and Iraq operations. PMID:24734435

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

    PubMed Central

    Redelmeier, Donald A.; Cialdini, Robert B.

    2002-01-01

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

  1. Medication errors in family practice, in hospitals and after discharge from the hospital: an ethical analysis.

    PubMed

    Clark, Peter A

    2004-01-01

    Thousands of medical errors are occurring daily in physician's offices, in hospitals, and even upon discharge from the hospital, leading to unnecessary injury and death and costing billions of dollars. We have a systems approach that has been proven to be tried and true in aviation, nuclear energy and many other industrial settings. Being honest when medical mistakes occur, reporting them to national clearing house, objectively searching for root causes, avoiding the fixing of arbitrary blame, and then, where possible, implementing safeguards to minimize the occurrence of future mistakes, is the best way to enhance patient safety. But until the medical establishment takes medical errors and patient safety more seriously, and until the general public rises up in protest, it is up to the state and federal governments to take the lead in protecting the lives of innocent Americans by creating a public policy. PMID:15301199

  2. Ethical Study on the Reform and Development of Medical and Health Services in China.

    PubMed

    Yang, Tong-Wei; Li, En-Chang

    2015-07-01

    At an early stage of its foundation, new China became clear about the nature of public welfare and quickly developed medical and health services, which was well received by the World Health Organization. The marketization and the reduction of input into medical and health services from the 1980s created severe adverse consequences. After the SARS' outbreak in 2003, China started to give serious consideration to its medical and health system, and to work at developing medical and health services. The new healthcare reform launched in 2009 re-emphasizes fairness and public welfare, and China's achievements have been remarkable. Of course, there are still many problems to be solved in the reform, which also paves the way for increasing the reform in future. PMID:25395061

  3. Ethical Issues within the Gerontological Nursing Curriculum.

    ERIC Educational Resources Information Center

    Bahr, Rose Therese

    This presentation focuses on ethical issues that need to be addressed within the gerontological nursing curriculum for preparing nurses to become change agents and catalysts in the health care of the older population. Ethics and ethical principles are defined, and three ethical principles are discussed: justice; beneficence; and autonomy.…

  4. The family rule: a framework for obtaining ethical consent for medical interventions from children.

    PubMed Central

    Foreman, D M

    1999-01-01

    Children's consent to treatment remains a contentious topic, with confusing legal precepts and advice. This paper proposes that informed consent in children should be regarded as shared between children and their families, the balance being determined by implicit, developmentally based negotiations between child and parent--a "family rule" for consent. Consistent, operationalized procedures for ethically obtaining consent can be derived from its application to both routine and contentious situations. Therefore, use of the "family Rule" concept can consistently define negligent procedure in obtaining consent from children, and could be used as a unifying framework in the development of new professional guidelines. A "guideline"-based approach to children's consent to treatment may offer greater individuality than a "rights"-based approach, though careful training and oversight will be needed for it to be effective. PMID:10635505

  5. [The ambiguity of the bioethics' principles].

    PubMed

    Pardo Caballos, Antonio

    2010-01-01

    The principles of the bioethics, coined in United States at the end of the seventies and diffused in our social environment one decade later, enclose inside a semantic ambiguity that here it is analyzed in their master lines; this ambiguity oscillates between a relativistic meaning and another agreed with the classic concept of Nature; this ambiguity has been transmitted to who, being part of the field of the Hippocratic medical ethics, have adopted its terminology, and these are the immense majority of the medical class. This phenomenon is easily leading towards the abandonment of the medical ethics based on the natural law (the Hippocratic-Christian tradition), to make it finish in a more or less clear relativism. to avoid this problem, some solutions in the field of the medical ethical terminology are proposed. PMID:20405972

  6. [Ethical aspects in end-of-life care].

    PubMed

    Nauck, F

    2011-10-01

    Therapy decisions in the care of critically ill and dying patients in intensive care and emergency medicine must reflect probably conflicting issues of medical indications, ethics and law. This is of particular relevance when treatment preferences of patients are not known or are in contrast to those of the carers. Difficulties regarding prognostication or with determining the beginning of an irreversible dying process may also lead to treatment situations that need ethical reflection. It is recommended to tackle medico-ethical issues by discussion of the meaning of relevant terms and medico-ethical principles, analyzing the professional self-image in intensive care and emergency medicine, consideration of options of palliative medicine and by use of an ethics case consultation. PMID:22038639

  7. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

    PubMed Central

    2014-01-01

    Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339

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

    PubMed

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

    2006-09-01

    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

  9. Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective.

    PubMed

    Pandit, M S; Pandit, Shobha

    2009-07-01

    A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment. PMID:19881134

  10. Ethics and clinical trials.

    PubMed

    Chassany, O; Duracinský, M

    1999-01-01

    The current reference guideline about ethics in clinical trials is the Declaration of Helsinki of human rights in medical research. Three major principles are emphasised: respect of the patient to accept or not to participate in a trial, the constraints and the presumed risks must be acceptable for patients included in a study, and vulnerable subjects should not participate in studies. The investigator is responsible for obtaining a free and well-informed consent from patients before their inclusion in a study. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. Else, a small-sized trial comparing a new drug versus a reference treatment can lead to an erroneous conclusion of absence of difference. Moreover, good results or improvement are obtained in at least 30% of cases with placebo, whatever the disease. The use of placebo is unethical in life-threatening diseases and when an effective proved drug exists. The use of placebo is ethical in severe diseases with no efficient drug, in some severe diseases even when an active reference treatment is available, and in all moderate and functional diseases. In order to detect flawed studies, most journals now ask for any manuscript submitted and reporting results of a randomised clinical trial to join a checklist in order to verify the quality of the trial. Finally, it remains the responsibility of the doctor to decide whether or not a protocol is ethical, to participate or not and to include patients or not. PMID:10456284

  11. Jehovah's Witness parents' refusal of blood transfusions: Ethical considerations for psychologists.

    PubMed

    Hoffman, Anna

    2014-12-01

    Psychologists in medical settings may be confronted with Jehovah's Witness parents refusing blood transfusions for their children as an ethical dilemma. The purpose of this discussion is to help psychologists provide informed, ethical consultations and support by investigating the values of the Jehovah's Witness community and the origin of the blood transfusion taboo, how medical and legal professionals have approached this dilemma, exploring relevant ethical principles and standards for psychologists, and suggestions for how to move toward a better understanding of harm with Jehovah's Witness families. PMID:25476572

  12. Philosophy of organ donation: Review of ethical facets

    PubMed Central

    Dalal, Aparna R

    2015-01-01

    Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

  13. Philosophy of organ donation: Review of ethical facets.

    PubMed

    Dalal, Aparna R

    2015-06-24

    Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail. PMID:26131406

  14. "Murder or mercy?" An innovative module helping UK medical students to articulate their own ethical viewpoints regarding end-of-life decisions.

    PubMed

    Bell, David; Crawford, Vivienne

    2011-10-01

    This module was designed to equip UK medical students to respond ethically and sensitively to requests encountered as qualified doctors regarding euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment.The module is delivered by a multidisciplinary team, providing students with the working knowledge to actively discuss cases, articulate their own views and practice ethical reasoning. Visits to intensive care units, palliative care wards and hospices are integrated with theory. Student assessment comprises a dissertation, debate and reflection. Module impact was evaluated by analysis of student coursework and a questionnaire.Students greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to cases and debate issues with peers. They reported increased discernment of the ethical and legal position and practical considerations and greater awareness of the range of professional and lay viewpoints held. Many participants were less strongly in favor of euthanasia and assisted dying on module completion than at the outset, but all of them believed they were better equipped to justify their own viewpoint and respond to patient requests. The multi-disciplinary nature of this course helps to prepare students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position. PMID:21941154

  15. Sickle Cell Screening: Medical, Legal, Ethical, Psychological and Social Problems; A Sickle Cell Crisis.

    ERIC Educational Resources Information Center

    Bowman, James E.

    In recent years, sickle cell screening programs have been initiated by community groups, health centers, hospitals, medical schools, health departments, school systems, city and State governments, various branches of the Federal Government, fraternal and social clubs, and other organizations. Problems have resulted from mass sickle cell screening,…

  16. Context and Process in Medical Ethics: The Contribution of Family-Systems Theory

    Microsoft Academic Search

    Michael A. Grodin; Laurel Arthur Burton

    1988-01-01

    Family practitioners, family therapists, and medical ethicists usually find their work independently of one another. Yet increasingly the management of complex and difficult cases requires the active collaboration of all three disciplines. This article reviews the concepts used by ethicists and suggests a model for the integration of these approaches to human problem solving.

  17. Human cloning and embryo research: the 2003 John J. Conley Lecture on medical ethics.

    PubMed

    George, Robert P

    2004-01-01

    The author, a member of the U.S. President's Council on Bioethics, discusses ethical issues raised by human cloning, whether for purposes of bringing babies to birth or for research purposes. He first argues that every cloned human embryo is a new, distinct, and enduring organism, belonging to the species Homo sapiens, and directing its own development toward maturity. He then distinguishes between two types of capacities belonging to individual organisms belonging to this species, an immediately exerciseable capacity and a basic natural capacity that develops over time. He argues that it is the second type of capacity that is the ground for full moral respect, and that this capacity (and its concomitant degree of respect) belongs to cloned human embryos no less than to adult human beings. He then considers and rejects counter-arguments to his position, including the suggestion that the capacity of embryos is equivalent to the capacity of somatic cells, that full human rights are afforded only to human organisms with functioning brains, that the possibility of twinning diminishes the moral status of embryos, that the fact that people do not typically mourn the loss of early embryos implies that they have a diminished moral status, that the fact that early spontaneous abortions occur frequently diminishes the moral status of embryos, and that his arguments depend upon a concept of ensoulment. He concludes that if the moral status of cloned human embryos is equivalent to that of adults, then public policy should be based upon this assumption. PMID:15180093

  18. The ethics of cardiopulmonary resuscitation. II. Medical logistics and the potential for good response.

    PubMed Central

    Davies, J M; Reynolds, B M

    1992-01-01

    Mismatches between provision of paediatric cardiopulmonary resuscitation (CPR) and potential to benefit are examined. Deficiencies are most likely to occur in peripheral maternity units but futile CPR is more common in emergency departments where the child is unknown. Decision making in individual cases is best retained by the medical profession for the sake of the child and family. American style intervention by the legislature is likely to dissipate scarce resources and perhaps harm infants not capable of benefiting. PMID:1489234

  19. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives’ perspectives

    PubMed Central

    Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca

    2013-01-01

    Objectives Medical tourism involves patients’ intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. Design We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Participants Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Results Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Conclusions Concern was expressed that medical tourism might have unintended and undesired effects upon patients’ home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose significant public health risks. PMID:23396563

  20. Ethical issues in geriatric medicine: a unique problematic?

    PubMed

    Kluge, Eike-Henner W

    2002-01-01

    It is commonly believed that geriatric medicine generates a distinctive set of ethical problems. Implicated are such issues as resource allocation, competence and consent, advance directives, medical futility and deliberate death. It is also argued that it would be unjust to allow the elderly to compete with younger populations for expensive and scarce healthcare resources because the elderly "have already lived," and that treating them the same as these other populations would diminish the available resources unfairly, prolong a life of inevitably failing health and result in increased health care expenditures. In fact, however, this perception of ethical uniqueness is mistaken. Differences in medical conditions, demographics and aetiology should not be allowed to obscure the fact that ethical issues in geriatric medicine are essentially the same as those faced in any other area of health care, and that the solutions that are adopted in the geriatric context must be consistent with the ethical principles that are followed elsewhere. The paper argues that the root of the mistaken perception lies in the abandonment of the Hippocratic mandate of medicine and in an unreflective adherence to the belief that medical advances are inevitably beneficial. It is suggested that a return to patient-centred medicine and the use of ethics impact analyses before introducing medical advances may be ethically appropriate. PMID:12814285

  1. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed Central

    Haines, A; de B White, C; Gleisner, J

    1983-01-01

    The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585

  2. Ethics fundamentals.

    PubMed

    Chambers, David W

    2011-01-01

    Ethics is about studying the right and the good; morality is about acting as one should. Although there are differences among what is legal, charitable, professional, ethical, and moral, these desirable characteristics tend to cluster and are treasured in dentistry. The traditional approach to professionalism in dentistry is based on a theory of biomedical ethics advanced 30 years ago. Known as the principles approach, general ideals such as respect for autonomy, nonmaleficence, beneficence, justice, and veracity, are offered as guides. Growth in professionalism consists in learning to interpret the application of these principles as one's peers do. Moral behavior is conceived as a continuous cycle of sensitivity to situations requiring moral response, moral reasoning, the moral courage to take action when necessary, and integration of habits of moral behavior into one's character. This essay is the first of two papers that provide the backbone for the IDEA Project of the College--an online, multiformat, interactive "textbook" of ethics for the profession. PMID:22263371

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

    ERIC Educational Resources Information Center

    Ingham, Janis C.; Minifie, Fred D.; Horner, Jennifer; Robey, Randall R.; Lansing, Charissa; McCartney, James H.; Slater, Sarah C.; Moss, Sharon E.

    2011-01-01

    Purpose: The purpose of this 2-part study was to determine the importance of specific topics relating to publication ethics and adequacy of the American Speech-Language-Hearing Association's (ASHA's) policies regarding these topics. Method: A 56-item Web-based survey was sent to (a) ASHA journal editors, associate editors, and members of the…

  4. Parental role in medical decision-making: fact or fiction? A comparative study of ethical dilemmas in French and American neonatal intensive care units

    Microsoft Academic Search

    Kristina Orfali

    2004-01-01

    Neonatal intensive care has been studied from an epidemiological, ethical, medical and even sociological perspective, but little is known about the impact of parental involvement in decision-making, especially in critical cases. We rely here on a comparative, case-based approach to study the parental role in decision-making within two technologically identical but culturally and institutionally different contexts: France and the United

  5. [Ethical medicine in Paracelsus].

    PubMed

    Engelhardt, D V

    1997-01-01

    The last decades have been an increasing interest in medical ethics. Paracelsus occupies an important place in the development of ethics in medicine in the crucial cultural passage between Middle Ages and Renaissance. Paracelsus' biography is in itself connected with ethical choices and theories. In his medical doctrines ethics is rooted in the belief in a strict correspondence between micro- and macrocosmos. Love is the basis on which a correct doctor-patient relationship can be built. Ilnesses are but episodes in the human life, and care for both spiritual and bodily health should dominate the entire life, and not ony the crucial moments of birth, sickness and death. PMID:11619967

  6. [Medical ethics, a counter-weight to the logics of the Perruche decree].

    PubMed

    François, Irène; Moutel, Grégoire; Bertrandon, Richard; Herve, Christian

    2002-07-27

    FROM A CONTRACTUAL LOGIC TO A PROBABILISTIC APPROACH: Since 1936, reflections on the relationship between the physician and the patient have progressed within the context of a contractual legal concept. Its contents have been based more on jurisprudence than on the physicians' reflections with regard to their practice. Associated with this contractual logic, some confusion exists between a lesion, a medical concept, and a handicap, which is the social consequence of one's status of health. This has been reinforced by the scientific progress made in medicine, which privileges a probabilistic approach based on scientific data, rather than the uncertainty, inscribed in the dialogue and singularity of the encounter. REGARDING THE PERRUCHE DECREE: We analyzed the reports submitted to the court of cessation regarding the Perruche affair, together with the first chapter of the law concerning the rights of the patients and the quality of health system, by studying the extent to which this decision was inscribed or not in the continuity of past legal decisions, and whether the characteristics described above were present. In this decree, the predominating contractual logic is that the notion of handicap is not analyzed, and the scientific and probabilistic conception of medical practice is involved in the debate. THE NECESSITY FOR REFLECTION: Our discussion insists on the necessity of constructing a reflection on the medical presentation; society cannot accept that this be reduced to the strict respect of the elements of the contract, defined by legal decisions. It should be carefully thought out by health professionals, and in collaboration with human science. PMID:12192727

  7. Medical Assistant. [FasTrak Specialization Integrated Technical and Academic Competency (ITAC).] 2002 Revision.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.

    This curriculum for a medical assistant program is designed for students interested in caring for the sick, injured, convalescent, or disabled under the direction of the family, physicians, and credentialed nurses. The curriculum is divided into 12 units: orientation to medical assisting; principles of medical ethics; risk management; infection…

  8. Ethical issues of managed care.

    PubMed

    Larkin, G L

    1999-05-01

    In a competitive, monetized medical system, a clash of principles is inevitable; however, amid the tumult in the medical marketplace, the underlying tenets of emergency medical ethics remain inviolate. Although the goals of providing excellent and cost-effective care are not mutually exclusive, the conflicts encountered can only be resolved by appeal to a higher goal: the good of the patient. Both MCOs and EPs must function as agents of individual patients first and foremost. The enterprise of healthcare rests on fidelity, integrity, and trust; therefore, physicians and MCOs must accept and take seriously their important moral, legal, and social obligations to patients and society. Otherwise, third-party cost considerations and provider greed irreversibly could pervert the practice of medicine and destroy the last vestiges of fidelity in the patient-physician relationship. PMID:10429636

  9. Brief History of pharmacy ethics in Iran

    PubMed Central

    Farsam, Hassan

    2009-01-01

    Pharmacy is an ethical profession. The aim of this study was to investigate the history of pharmacy ethics in Iran. In the ancient Persia, medical and pharmaceutical ethics were related to religious rules, and everybody had to respect it. The ethical rules were similar to some current pharmacy ethics. During Islamic era, the pharmacy ethics were edited according to the Islamic rules. After introduction of European pharmacy into Iran, the pharmacy ethics did not change and was regarded as before. By presentation of bioethics and medical ethics in recent years, new activities are carried out for better manipulation of their rules in health professions including pharmacy. PMID:23908727

  10. Critical reflections on the principle of beneficence in biomedicine.

    PubMed

    Munyaradzi, Mawere

    2012-01-01

    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". PMID:22514763

  11. Research governance: ethical issues

    Microsoft Academic Search

    Anne Slowther; Petra Boynton; Sara Shaw; Trisha Greenhalgh

    2006-01-01

    SUMMARY Healthcare research is haunted by a history of unethical studies in which profound harm was caused to vulnerable individuals. Official systems for gaining ethical approval for research, designed to prevent a repetition of these shameful examples, can prove bureaucratic and inflexible in practice. The core ethical principles of respect for autonomy, prevention of harm, promotion of benefit, and justice

  12. Ethics of prenatal ultrasound.

    PubMed

    Howe, David

    2014-04-01

    Prenatal ultrasound has opened new opportunities to examine, diagnose and treat the fetus, but these advances bring with them ethical dilemmas. In this chapter, I address the ethical principles that need to be considered when treating both mother and fetus as patients, and how these can be applied in practice. In particular, ultrasound practitioners have an ethical duty to maintain their theoretical knowledge and practical skills to ensure they advise parents correctly. I also discuss the ethical issues in carrying out intrauterine therapy, ultrasound-related research, and termination of pregnancy for fetal abnormality. PMID:24374013

  13. Ethical reflections on the thoughts and lives of Kurosawa's doctors.

    PubMed

    Asai, Atsushi; Maki, Sakiko; Kadooka, Yasuhiro

    2012-06-01

    The year 2010 marked the centenary of the birth of Akira Kurosawa (1910-1998), whose works have been reassessed favourably in the last couple of years in Japan. During his lifetime, Kurosawa directed and produced three films whose chief characters are medical doctors: Drunken Angel (1948), The Quiet Duel (1949) and Red Beard (1965). This paper discusses these three films and examines the thoughts and lives of the three protagonists from the perspective of modern medical ethics. The films depict contemporary ethical and social problems, and deal with paternalism, a healthy professional life and the proper place for human reason in medicine, all of which still give rise to debate in modern medical settings. They are very impressive in their portrayal of extreme paternalism, excessively professional lives and disproportionate reliance on rationality. The doctors are role models in certain situations and are examples of how not to behave in other situations. On the one hand, they are devoted to helping their patients, with their self-sacrifice firmly based on humanity and medical ethics. On the other hand, they perform unwelcome favours and are unhealthy role models who might harm others through narrow-minded attitudes about human beings, a fixed view of life and inflexible ideas about medicine. In this sense, they can be regarded as a rather mixed blessing. These films provide us with an opportunity to simultaneously recognise the importance of modern ethical principles and the significance of 'old' ethical values. PMID:22282423

  14. Resolving ethical dilemas. Applying the institute for Global Ethics' Ethical Fitness model to occupational and environmental health practice issues.

    PubMed

    Edgar, Patricia H

    2002-01-01

    1. Technological advancements have rapidly increased the need for careful ethical choices to preserve life and environment of the global community. 2. No formula exists to resolve ethical dilemmas, but using an ethical decision making model can help maintain a state of ethical fitness. 3. The Ethical Fitness model relies on the assumption that certain core values are universal. Maintaining ethical fitness is essential to resolve ethical dilemmas. 4. The process of resolving ethical dilemmas consists of analyzing the dilemma using nine checkpoints, four dilemma paradigms, and three resolution principles. PMID:11842780

  15. Situating Ethics in Games Education

    ERIC Educational Resources Information Center

    Butler, Joy

    2013-01-01

    This paper posits that Inventing Games (IG), an aspect of the games curriculum based on principles of Teaching Games for Understanding (TGfU), opens up important spaces for teaching social and ethical understanding. Games have long been regarded as a site for moral development. For most teachers, however, ethical principles have been seen as…

  16. [Focus on the ethics problem in glaucoma management].

    PubMed

    Zhang, Chun; Shi, Yan; Zhang, Yu; Huang, Ping

    2015-02-01

    Due to the different goals of current glaucoma treatments, various treatment methods have their pros and cons. Therefore, their applications are affected by factors inside and outside medical category, thus prone to a series of problems.In clinical practice, in addition to following the related clinical guidelines and standards, medical ethics problems must be considered. And besides, based on the principles of nonmaleficence, beneficence, respect and justice in medical ethics, the treatments should be carefully selected to weigh the advantages and disadvantages to the patients.Only in this way, the efficacy and safety of glaucoma treatment can be improved, and the medical and social missions of glaucoma specialists can be more reasonably completed. PMID:25907998

  17. An Ethics Primer: Ethical Questions

    NSDL National Science Digital Library

    2008-01-01

    This resource is a PDF that provides a short introduction to ethical questions and strategies having to do with Ethics instruction. The PDF describes an overview of ethical questions and develops student understanding of ethical questions through three different worksheets.

  18. Public Health Ethics: Establishing “Durable Solutions” Within the Global Polio Eradication Initiative in Nigeria

    Microsoft Academic Search

    Tiffany T. Mason

    2009-01-01

    Discussions on public health ethics often appeal to the same codes of conduct established in the field of bioethics. Principles of bioethics contribute to the morality of the study of public health—proposing an optimal code of conduct in the medical care and human research aspects of the field. For example, public health researchers are aware of their obligations to consider

  19. Philosophy, Ethics, and Humanities in Medicine: Expanding the open-access conversation on health care

    Microsoft Academic Search

    Dan J Stein; Derek Bolton; Damiaan Denys; Thomas Huddle; Tia Powell

    2006-01-01

    Natural philosophy once spanned the fields of philosophy, science, and medicine. Scientific disciplines and medical specialties have rapidly achieved independence, and the availability of the internet and open-access publishing promises a further expansion of knowledge. Nevertheless, a consideration of the grounding concepts and ethical principles that underlie health care remains paramount. It is timely, therefore, to contribute to the global

  20. The Ethical Use of Placebo Controls in Clinical Research: The Declaration of Helsinki

    Microsoft Academic Search

    Theodore J. La Vaque; Thomas Rossiter

    2001-01-01

    Medical ethicists have questioned the use of no-treatment (placebo and sham procedure) controlled studies of new therapies when safe and effective standard therapies are available for use as an active or “equivalence” control. Current ethical principles of conduct for biomedical research specifically prohibit designs that withhold or deny “the best proven diagnostic and therapeutic” treatment to any participant in a

  1. A principled and cosmopolitan neuroethics: considerations for international relevance

    PubMed Central

    2014-01-01

    Neuroethics applies cognitive neuroscience for prescribing alterations to conceptions of self and society, and for prescriptively judging the ethical applications of neurotechnologies. Plentiful normative premises are available to ground such prescriptivity, however prescriptive neuroethics may remain fragmented by social conventions, cultural ideologies, and ethical theories. Herein we offer that an objectively principled neuroethics for international relevance requires a new meta-ethics: understanding how morality works, and how humans manage and improve morality, as objectively based on the brain and social sciences. This new meta-ethics will simultaneously equip neuroethics for evaluating and revising older cultural ideologies and ethical theories, and direct neuroethics towards scientifically valid views of encultured humans intelligently managing moralities. Bypassing absolutism, cultural essentialisms, and unrealistic ethical philosophies, neuroethics arrives at a small set of principles about proper human flourishing that are more culturally inclusive and cosmopolitan in spirit. This cosmopolitanism in turn suggests augmentations to traditional medical ethics in the form of four principled guidelines for international consideration: empowerment, non-obsolescence, self-creativity, and citizenship. PMID:24387102

  2. Forum Response: Ethics in Business and Teaching.

    ERIC Educational Resources Information Center

    Anderson, James A.

    2003-01-01

    Discusses the teaching of business ethics. Draws conclusions about teaching business ethics noting that such instruction must start with the principles of capitalism and the functions of a market economy. (SG)

  3. Healthcare ethics: the experience after the Haitian earthquake.

    PubMed

    Etienne, Mill; Powell, Clydette; Amundson, Dennis

    2010-01-01

    On January 12, 2010, a 7.0 Richter earthquake devastated Haiti and its public health infrastructure leading to a worldwide humanitarian effort. The United States sent forces to Haiti's assistance including the USNS Comfort, a tertiary care medical center on board a ship. Besides setting a transparent triage and medical regulating system, the leadership on the Comfort instituted a multidisciplinary Healthcare Ethics Committee to assist in delivering the highest level efficient care to the largest number of victims. Allocation of resources was based on time-honored ethics principles, the concept of mass casualty triage in the setting of resource constraints, and constructs developed by the host nation's Ministry of Health. In offering aid in austere circumstances, healthcare practitioners must not only adhere to the basic healthcare ethics principles but also practice respect for communities, cultures, and traditions, as well as demonstrate respect for the sovereignty of the host nation. The principles outlined herein should serve as guidance for future disaster relief missions. This work is in accordance with BUMEDINST 6010.25, Establishment of Healthcare Ethics Committees. PMID:20701171

  4. Competency Professionalism Sub Domain Ethical and Legal Understanding

    E-print Network

    Leistikow, Bruce N.

    ) · Systematically and routinely analyzes ethical issues in clinical care (1) · Demonstrate ethics-specific clinical framework of ethical decision-making in addressing ethical issues and conflicts 2. Demonstrates familiarity principles, codes of professional conduct, legal mandates and personal morality in ethical decision- making

  5. Portrayal of negative qualities in a doctor as a potential teaching tool in medical ethics and humanism: Journey to the End of Night by Louis?Ferdinand Céline

    PubMed Central

    Wolf, G

    2006-01-01

    Fictional stories about physicians and patients are increasingly used as a powerful teaching resource for medical students. Very often, but not exclusively, stories of physicians as positive role models are selected to teach students virtues and ethical values. Negative role models are rarely used and if so, physicians are rather described as medical quacks in such fiction then exhibiting primarily a corrupted character. I suggest that a fictional story that presents exclusively a negative role model of a physician could also be a valuable, admittedly difficult, teaching resource to demonstrate the consequences of absolute loss of ethical standards and virtues in physicians. A not widely known example of this genre is Louis?Ferdinand Céline's (1894–1961) novel Voyage au bout de la nuit (Journey to the End of the Night), published in 1932. Having a strong autobiographical background, the novel described the adventures of the medicine student, Ferdinand Bardamu, during the first world war, in the African colonies as a trader, in the United States of America as factory worker, and later after finishing his education, as a doctor for the poor. Unfortunately, Dr Bardamu develops an unprofessional, even criminal behaviour, and may serve as a negative role model for the virtues of physicians. This article will familiarise the reader with the novel and its physician author. PMID:16461481

  6. Ethical Issues in the Consulting Context--Ethics in Presentation Skills Training.

    ERIC Educational Resources Information Center

    Ray, Rebecca L.

    In light of the huge volume of headline news stories that reflect ethical concerns from a variety of arenas, it is no wonder that ethics training is a hot topic. Research shows that many leading United States companies have written codes of ethics and/or instituted formal ethics training programs. In this paper, certain principles that have become…

  7. Bioethics in practice: Addressing ethically sensitive requests in a Dutch fertility clinic.

    PubMed

    Gerrits, Trudie; Reis, Ria; Braat, Didi D M; Kremer, Jan A M; Hardon, Anita P

    2013-12-01

    This article provides insight into how ethically sensitive requests for the use of assisted reproductive technologies (ARTs) are dealt within the daily practice of a Dutch fertility clinic. The findings presented are part of an ethnographic study conducted in this clinic from September 2003 until April 2005. Information for this article was gathered by attending the multidisciplinary ethics meetings and conversations with clinic staff. By looking at 'bioethics in practice', this article provides insight into the complex and dynamic interplay between particular couples' situations, contextual features, bioethical principles, doctors' subjective feelings and views, and the employment of medical practices. Our study suggests that personal views to a certain extent inform the agenda of the ethics meetings, but in the end neither these views nor bioethical principles fully determine the decisions made. Clinic staff members employ routine medical practices with the intention to carefully resolve ethically sensitive cases. These practices include: collegial consultation, searching for scientific evidence in the literature, obtaining more medical information, offering medical tests, referring couples to other clinics and ensuring informed consent. Rather than examining hypothetical cases, which evoke principles, observations of practices regarding real life cases of which many details are known, allowed us to identify the influence of routine medical practice on ethical decisions. Despite initial concerns from the side of the medical professionals (some of which might be regarded as paternalistic), at the end the reproductive autonomy of most couples seeking ARTs was not jeopardized. The format of the multidisciplinary ethics meetings seems to be promising as it provides a space for clinic staff members to express and reflect on their subjective views and feelings of unease regarding certain requests for ARTs, while at the same time it diminishes the risk that decision making is (too heavily) shaped by these feelings and views. PMID:23422313

  8. Medical Education and the Pharmaceutical Industry: A Review of Ethical Guidelines and Their Implications for Psychiatric Training

    ERIC Educational Resources Information Center

    Geppert, Cynthia M. A.

    2007-01-01

    Objective: This article reviews and summarizes eight ethical guidelines of major professional organizations regarding the pharmaceutical industry's role in the psychiatric education of trainees. Method: The author conducted a literature review of research and guidelines pertaining to the pharmaceutical industry's relationship to trainees, with…

  9. Ethical Issues in Paediatric Practice - Part II: Issues relating to disability

    PubMed Central

    Attard-Montalto, S

    2002-01-01

    Ethical issues in child care are often complicated by the child's inability to take responsibility in their own management decisions and, therefore, their reliance on third parties. This situation is further complicated in those children who have an underlying disability which may influence judgement decisions of the child's surrogate guardians, both toward over or under treatment. This is particularly the case with regard to decisions relating to life support, ongoing and quality of life, appropriate use of limited healthcare resources, and medical research. This article will explore the ethical principles which help to guide the medical management of such difficult cases. PMID:22368609

  10. Review by a local medical research ethics committee of the conduct of approved research projects, by examination of patients' case notes, consent forms, and research records and by interview.

    PubMed Central

    Smith, T.; Moore, E. J.; Tunstall-Pedoe, H.

    1997-01-01

    OBJECTIVE: To monitor the conduct of medical research projects that have already been approved by the local medical research ethics committee. DESIGN: Follow up study of ethically approved studies (randomly selected from all the studies approved in the previous year) by examination of patients' case notes, consent forms, and research records and by interview of the researchers at their workplace. SETTING: Tayside, Scotland (mixed rural and urban population). SUBJECTS: 30 research projects approved by Tayside local medical research ethics committee. MAIN OUTCOME MEASURES: Adherence to the agreed protocol, particularly for recruitment (obtaining and recording informed consent) and for specific requirements of the ethics committee, including notification of changes to the protocol and of adverse events. RESULTS: In one project only oral consent had been obtained, and in a quarter of the studies one or more consent forms were incorrectly completed. Inadequate filing of case notes in five studies and of consent forms in six made them unavailable for scrutiny. Adverse events were reported, but there was a general failure to report the abandoning or non-starting of projects in two studies the investigators failed to notify a change in the responsible researcher. CONCLUSIONS: Monitoring of medical research by local medical research ethics committees promotes and preserves ethical standards, protects subjects and researchers, discourages fraud, and has the support of investigators. We recommend that 10% of projects should undergo on-site review, with all others monitored by questionnaire. This would require about six person hours of time and a salary bill of 120 pounds per study monitored. PMID:9169403

  11. Shared medical decision-making: considering what options to present based on an ethical analysis of the treatment of brain tumors in very young children.

    PubMed

    Levine, Deena; Cohen, Kenneth; Wendler, David

    2012-08-01

    The treatment of brain tumors in very young children poses both a therapeutic challenge and a bioethical quandary. The administration of craniospinal radiation after surgery offers the greatest chance for cure but causes severe neurocognitive damage. As a result, current practice does not offer parents the option of full-dose postoperative craniospinal radiation. Some may regard this approach as inappropriate medical paternalism, while others may consider it an example of responsible therapeutics. Evaluation of this dilemma reveals principles which can guide clinicians in determining which treatment options to present to their patients or surrogates, in the context of shared medical decision-making. PMID:22522647

  12. Principles and Paradigms Used in Human Medical Ethics Can Be Used as Models for the Assessment of Animal Research

    Microsoft Academic Search

    Gerald L. Van Hoosier

    The preparation of the Obrink Memorial Lecture for presen- tation to the Scandinavian Association of Laboratory Animal Science (1) provided me with an impetus for further reading and thinking about IACUC review of research protocols using animals. One of the primary responsibilities of laboratory ani- mal specialists and comparative medicine scientists is to bridge the worlds of the investigator, the

  13. Exploring the ethics of prescribing medicines.

    PubMed

    Jackson, Jan

    2010-05-01

    The delivery of holistic care should incorporate patient empowerment through the promotion of health and self-help measures, including pain relief. In this article, the author, a newly qualified independent prescriber, explains why she believes that encouraging patients to buy over-the-counter medication is morally acceptable and based on the principles of beneficence and non-malevolence. She also reflects on her prescribing decisions in the context of ethics, health economics and personal perspective for four patients with similar injuries. The author works in Wales, where prescriptions are free to residents. PMID:20527454

  14. Perspectives on key principles of generalist medical practice in public service in sub-saharan africa: a qualitative study

    PubMed Central

    2011-01-01

    Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational than real. Conclusions The study derived a set of principles for the practice of generalist doctors in sub-Saharan Africa based on the reported activities and approaches of the respondents. Patient-centred care using a biopsychosocial approach remains as a common core principle despite wide variations in context. Procedural and hospital care demands a higher level of skills particularly in rural areas, and a community orientation is desirable, but not widely practiced. The results have implications for the postgraduate training of family physicians in sub-Saharan Africa, and highlight questions regarding the realization of community-orientated primary care. PMID:21726454

  15. Optimizing technology development and adoption in medical imaging using the principles of innovation diffusion, part II: practical applications.

    PubMed

    Reiner, Bruce I

    2012-02-01

    Successful adoption of new technology development can be accentuated by learning and applying the scientific principles of innovation diffusion. This is of particular importance to areas within the medical imaging practice which have lagged in innovation; perhaps, the most notable of which is reporting which has remained relatively stagnant for over a century. While the theoretical advantages of structured reporting have been well documented throughout the medical imaging community, adoption to date has been tepid and largely relegated to the academic and breast imaging communities. Widespread adoption will likely require an alternative approach to innovation, which addresses the heterogeneity and diversity of the practicing radiologist community along with the ever-changing expectations in service delivery. The challenges and strategies for reporting innovation and adoption are discussed, with the goal of adapting and customizing new technology to the preferences and needs of individual end-users. PMID:21769690

  16. Incorporating the principles of the patient-centered medical home into a student-run free clinic

    PubMed Central

    Riddle, Megan C; Lin, Jiahui; Steinman, Jonathan B; Salvi, Joshua D; Reynolds, Margaret M; Kastor, Anne S; Harris, Christina; Boutin-Foster, Carla

    2014-01-01

    As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH) as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC), a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87% were very or extremely satisfied with their care, and 96% of the patients would recommend the WCCC to others. Students who participate in the WCCC gain hands-on experience in coordinating care, providing continuity of care, addressing issues of accessibility, and developing quality and safety metrics. The WCCC experience provides an integrative model that links service-learning with education on health care delivery in a primary care setting. The authors propose that adoption of this approach by other student-run clinics provides a substantial opportunity to improve medical education nationwide and better prepare future physicians to practice within this new model of health care delivery. PMID:25246814

  17. Ethical and Legal Considerations

    Microsoft Academic Search

    Ira J. Kodner; Mark Siegler; Daniel M. Freeman; William T. Choctaw

    \\u000a Professional responsibilities have been a concern of surgeons since antiquity; however, the last 25 years have displayed a\\u000a dramatic growth of both professional and societal attention to moral and ethical issues involved in the delivery of health\\u000a care. This increased interest in medical ethics has occurred because of factors such as the greater technological power of\\u000a modern medicine, the assigning

  18. The Ethics of Special Education. Professional Ethics in Education Series.

    ERIC Educational Resources Information Center

    Howe, Kenneth R.; Miramontes, Ofelia B.

    This book takes a case-based approach to ethical reflection of concern to special educators and other education professionals. After an introductory chapter, Chapter 2 is devoted to philosophical concerns surrounding the nature of moral philosophy and ethical deliberation. "Principle-based" and "virtue-based" moral theories are contrasted, and the…

  19. Medical marijuana: should minors have the same rights as adults?

    PubMed

    Clark, Peter A

    2003-06-01

    After reviewing the pertinent scientific data, it is clear that there is more than sufficient medical and ethical evidence to warrant the Bush Administration to authorize the Drug Enforcement Agency to reclassify marijuana as a Schedule II drug so that it can be used for medical purposes. Failure to give an effective therapy to seriously ill patients, either adults or children, violates the core principles of both medicine and ethics. Medically, to deny physicians the right to prescribe to their patients a therapy that relieves pain and suffering violates the physician-patient relationship. Ethically, failure to offer an available therapy that has proven to be effective violates the basic ethical principle of nonmaleficence, which prohibits the infliction of harm, injury, or death and is related to the maxim primum non nocere ('above all, or first, do no harm'), which is widely used to describe the duties of a physician. Therefore, in the patient's best interest, patients and parents/surrogates, have the right to request medical marijuana under certain circumstances and physicians have the duty to disclose medical marijuana as an option and prescribe it when appropriate. The right to an effective medical therapy, whose benefits clearly outweigh the burdens, must be available to all patients including children. To deny children the use of medical marijuana when appropriate is a grave injustice which violates the basic foundational beliefs of both medicine and PMID:12824939

  20. GOOD MEDICAL PRACTICE

    Microsoft Academic Search

    Kerry J Breen; MB BS; Stephen M Cordner; Dip Crim

    Good Medical Practice: Professionalism, Ethics and Law brings together the infor- mation central to the professional, ethical and legal requirements of being a doctor. It covers a core curriculum for medical students, doctors in training and international medical graduates preparing for the Australian Medical Council examinations. It will also be useful for busy doctors looking for answers to issues that

  1. Palliative care research: trading ethics for an evidence base

    PubMed Central

    Jubb, A

    2002-01-01

    Good medical practice requires evidence of effectiveness to address deficits in care, strive for further improvements, and justly apportion finite resources. Nevertheless, the potential of palliative care is still held back by a paucity of good evidence. These circumstances are largely attributable to perceived ethical challenges that allegedly distinguish dying patients as a special client class. In addition, practical limitations compromise the quality of evidence that can be obtained from empirical research on terminally ill subjects. This critique aims to appraise the need for focused research, in order to develop clinical and policy decisions that will guide health care professionals in their care of dying patients. Weighted against this need are tenets that value the practical and ethical challenges of palliative care research as unique and insurmountable. The review concludes that, provided investigators compassionately apply ethical principles to their work, there is no justification for not endeavouring to improve the quality of palliative care through research. PMID:12468651

  2. Ethics in practice: managed care and the changing health care environment: medicine as a profession managed care ethics working group statement.

    PubMed

    Povar, Gail J; Blumen, Helen; Daniel, John; Daub, Suzanne; Evans, Lois; Holm, Richard P; Levkovich, Natalie; McCarter, Alice O; Sabin, James; Snyder, Lois; Sulmasy, Daniel; Vaughan, Peter; Wellikson, Laurence D; Campbell, Amy

    2004-07-20

    Cost pressures and changes in the health care environment pose ethical challenges and hard choices for patients, physicians, policymakers, and society. In 2000 and 2001, the American College of Physicians, with the Harvard Pilgrim Health Care Ethics Program, convened a working group of stakeholders--patients, physicians, and managed care representatives, along with medical ethicists--to develop a statement of ethics for managed care. The group explored the impact of a changing health care environment on patient-physician relationships and how to best apply the principles of professionalism in this environment. The statement that emerged offers guidance on preserving the patient-clinician relationship, patient rights and responsibilities, confidentiality and privacy, resource allocation and stewardship, the obligation of health plans to foster an ethical environment for the delivery of care, and the clinician's responsibility to individual patients, the community, and the public health, among other issues. PMID:15262669

  3. [Xenotransplantation from the ethical viewpoint. An outline].

    PubMed

    Beckmann, J P

    1999-01-01

    The duty to save and to preserve lives on one hand, and the scarcity of human donor organs on the other hand call for a search for new organ sources, including xenogenic ones. Xenotransplantation, however, is not only in need of medical research, but also of ethical analysis. The latter is not to be considered a substitute for moral intuition, but rather a foundation of it by way of a critical evaluation of the ethical principles and reasons involved. This basically demands an analysis of the legitimacy of the aims and of the acceptability of the means for xenotransplantation. It includes safeguarding informed consent; risk assessment and the protection of not only the recipient, but also others; the question of limitation of personal rights; allocation problems; and last but not least animal protection. The aim is to clarify the ethical status of xenotransplantation in general and the question of a moratorium regarding clinical trials due to unsolved problems of infectivity and immunosuppression in particular by way of an integrative approach to both scientific developments and ethical analysis. PMID:10474878

  4. Bioethics for clinicians: 10. Research ethics.

    PubMed

    Weijer, C; Dickens, B; Meslin, E M

    1997-04-15

    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 study participants. Beneficence demands a favourable balance between the potential benefits and harms of participation. Justice requires that vulnerable people not be exploited and that eligible candidates who may benefit from participation not be excluded without good cause. Studies must be designed in a way that ensures the validity of findings and must address questions of sufficient importance to justify the risks of participation. In any clinical trial there must be genuine uncertainty as to which treatment arm offers the most benefit, and placebo controls should not be used if effective standard therapies exist. Researchers have a responsibility to inform themselves about the ethical, legal and policy standards that govern their activities. When difficulties arise, they should consult the existing literature and seek the advice of experts in research ethics. PMID:9141987

  5. Emotions, narratives, and ethical mindfulness.

    PubMed

    Guillemin, Marilys; Gillam, Lynn

    2015-06-01

    Clinical care is laden with emotions, from the perspectives of both clinicians and patients. It is important that emotions are addressed in health professions curricula to ensure that clinicians are humane healers as well as technical experts. Emotions have a valuable and generative role in health professional ethics education.The authors have previously described a narrative ethics pedagogy, the aim of which is to develop ethical mindfulness. Ethical mindfulness is a state of being that acknowledges everyday ethics and ethically important moments as significant in clinical care, with the aim of enabling ethical clinical practice. Using a sample narrative, the authors extend this concept to examine five features of ethical mindfulness as they relate to emotions: (1) being sensitized to emotions in everyday practice, (2) acknowledging and understanding the ways in which emotions are significant in practice, (3) being able to articulate the emotions at play during ethically important moments, (4) being reflexive and acknowledging both the generative aspects and the limitations of emotions, and (5) being courageous.The process of writing and engaging with narratives can lead to ethical mindfulness, including the capacity to understand and work with emotions. Strategies for productively incorporating emotions in narrative ethics teaching are described. This can be a challenging domain within medical education for both educators and health care students and thus needs to be addressed sensitively and responsibly. The potential benefit of educating health professionals in a way which addresses emotionality in an ethical framework makes the challenges worthwhile. PMID:25853684

  6. Responsible Oversight of Human Stem Cell Research: The California Institute for Regenerative Medicine's Medical and Ethical Standards

    Microsoft Academic Search

    Geoffrey P. Lomax; Zach W. Hall; Bernard Lo

    2007-01-01

    California voters recently approved $3 billion over 10 years for public funding of stem cell research through the California Institute for Regenerative Medicine (CIRM). Geoffrey Lomax and colleagues discuss the principles that guided the CIRM regulations.

  7. Council Adopts New AERA Code of Ethics: Ethics Committee to Emphasize Ethics Education

    ERIC Educational Resources Information Center

    Herrington, Carolyn D.

    2011-01-01

    At its February 2011 meeting, the AERA Council adopted unanimously a new Code of Ethics. The Code articulates a set of standards for education researchers in education and provides principles and guidance by which they can build ethical practices in professional, scholarly, and scientific activities. The Code reflects the Association's strong…

  8. The ethics of drug development and promotion: the need for a wider view.

    PubMed

    Brody, Howard

    2012-11-01

    Ethical issues at the interface between the medical profession and the pharmaceutical industry have generally been approached from the vantage point of medical professionalism, with a focus on conflict of interest as the key ethical concern. Although conflicts of interest remain important, other ethical issues may be obscured unless a wider perspective is adopted. Besides medical professionalism, the ethics of the clinical therapeutic relationship, ethics of public health, and business ethics all provide additional insights. PMID:23047778

  9. Principles and applications of polymerase chain reaction in medical diagnostic fields: a review

    PubMed Central

    Valones, Marcela Agne Alves; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; de Souza, Paulo Roberto Eleutério; de Albuquerque Tavares Carvalho, Alessandra; Crovela, Sergio

    2009-01-01

    Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances. PMID:24031310

  10. The application of Belmont Report principles to policy development.

    PubMed

    Adams, David P; Miles, Toni P

    2013-12-01

    Attention to ethical issues is a routine part of medical research. In this article, we propose that health policy development, like research, include a formal review of these issues. Ethical knowledge is a critical component of epistemology and inherent in development of laws and principles of justice. However, we cannot assume that new policies are subject to a formal ethics review. The Belmont Report of 1978 provides a platform for this process. Prior to the Belmont Report, there was no foundation defining this process in medical research. Based on this history, we propose that health care payment policy development include a formal assessment of risks and benefits using an approach that is familiar to all researchers. PMID:24219075

  11. The importance of ethic in the field of human tissue banking.

    PubMed

    Morales Pedraza, Jorge; Herson, Marisa Roma

    2012-03-01

    A tissue bank is accountable before the community in fulfilling the expectations of tissue donors, their families and recipients. The expected output from the altruistic donation is that safe and high quality human tissue grafts will be provided for the medical treatment of patients. Thus, undertakings of tissue banks have to be not only authorised and audited by national competent health care authorities, but also comply with a strong ethical code, a code of practices and ethical principles. Ethical practice in the field of tissue banking requires the setting of principles, the identification of possible deviations and the establishment of mechanisms that will detect and hinder abuses that may occur during the procurement, processing and distribution of human tissues for transplantation. The opinions and suggestions manifested by the authors in this paper may not be necessarily a reflection of those within the institutions or community they are linked to. PMID:21161412

  12. Ethics in Trichology

    PubMed Central

    Padmanabhan, Parvathi

    2010-01-01

    Today, trichology as a science is offered by reputed institutes worldwide with a planned curriculum of theory and clinical exposure. Non-medical trichologists, with rare exceptions, continue to lure the public with unscientific methods. A qualified dermatologist equipped with knowledge of hair biology is undoubtedly the most competent to deal with hair problems. We are all indisputably governed by a basic code of medical ethics as we are doctors first and last. Hence, a dermatologist/trichologist cannot have another set of ethics. Having said that, we cannot discount the fact that there are special clinical situations where guidelines already exist or need to be established with compliance to the base code of ethics. PMID:21188023

  13. Principles of administration revisited

    Microsoft Academic Search

    John Donaldson; Irene Fafaliou

    2007-01-01

    Purpose – To explore the assumptions underlying the traditional “principles of administration” in the light of the rise of interest in corporate social responsibility, business ethics and corporate governance and to link revised principles to practical stakeholder models, using, for example, modern communications media. Design\\/methodology\\/approach – Using concepts of “fit” between traditional administrative principles and common problems of business administration,

  14. [The Nazis, guide of the International Conference of Harmonization and ethics committees].

    PubMed

    Palma-Aguirre, José Antonio; Rebollo-Franco, Dalia Irene; Gómez-Delgado, Alejandro; Villa-Caballero, Leonel

    2003-01-01

    This article begins with the basic ethical principles in clinical research. The four moral principles of autonomy, beneficence, non-maleficence, and justice are reviewed. Likewise, a historical review of the participation of German physicians and the medical establishment that carried out the policies of the Third Reich is examined, and delineates several moral failures attributable to these physicians during the dark period of history known as the Holocaust. Medical ethics were completely ignored during that period, and thus, the Nuremberg Code was enacted for regulating human research by means of informed consent. A historical vision of the universal documents for ethics in clinical research has been reviewed from the Declaration of Helsinki in 1964 to the ICH Guideline (International Conference of Harmonisation) for Good Clinical Practice (GCP) in 1996. The ICH Guideline is an international ethical and scientific quality standard for designing, conducting, recording, and reporting trials that involve participation of human subjects. The guide was developed with consideration of the current GCP of the European Union, Japan, and the U.S. Finally, we establish the composition, functions, and operations of the Ethic Committees that ensure the rights, safety, well-being, and confidentiality statement of subjects who participate in clinical research studies and document that protection by reviewing and approving/rejecting a study protocol, and evaluate research personnel, the research site, and materials and methods used for obtaining and recording informed consent protocol from subjects participating in the study. PMID:14574765

  15. Ethical Dilemmas in Today's Nuclear Medicine and Radiology Practice

    Microsoft Academic Search

    Bruce J. Barron; E. Edmund Kim; M. D. Anderson

    Throughout history, societies have developed their own codes of ethics, including those pertaining to the practice of medicine. In the United States, physicians have adopted a set of ethics based on religious values and historical teachings. We, as phy- sicians, have been presented several codes of ethics, including the American Medical Association Code of Ethics and the Amer- ican College

  16. EthicsConRep

    Cancer.gov

    The authors also gratefully acknowledge the copy editing assistance of Leslie Alter, MPH and Steve Brown. The Ethical Force Program’s initiative on patient-centered communication is funded in part by the American Medical Association Foundation, The California Endowment, the Commonwealth Fund and the Connecticut Health Foundation.

  17. Ethical Issues in Pharmacogenetics

    NSDL National Science Digital Library

    Carol Isaacson Barash (Genetics, Ethics & Policy Consulting, Inc.; )

    2001-02-01

    The issue-focused, peer-reviewed article illustrates how pharmacogenetics promises drugs specific to an individual's condition. However, it poses some ethical concerns: invasion of medical privacy, unequal distribution of benefits, discrimination because it involves genetic tests, and research/business conflict-of-interest.

  18. XENOTRANSPLANTATION - ETHICAL CONSIDERATIONS

    Microsoft Academic Search

    António Ramos

    2007-01-01

    Interest for xenotransplantation occurred in medical and scientific areas, because it could offer the potential to suppress the shortages of tissues and\\/or organs for transplant. However, xenotransplantation give rise to certain ethical problems related with receptor and donors selection, infection risk, economical factors and research conditions.

  19. The Social and Ethical Implications of Changing Medical Technologies: The Views of People Living with Genetic Conditions

    Microsoft Academic Search

    Elizabeth Chapman

    2002-01-01

    This article presents empirical data on subjective levels of health and quality of life for individuals with early- or late-onset genetic conditions. Twelve adults with an early-onset condition (cystic fibrosis) and 12 adults with a late-onset condition in the family (Huntington’s disease) participated in semi-structured interviews. Questions investigated perceptions of the body, quality of life and views on medical technology

  20. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

    PubMed Central

    Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2013-01-01

    In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide an update of selected topics that have evolved since 2005. PMID:24225486

  1. [Research ethics: the case with the tule (kuna), Urabbá, Colombia].

    PubMed

    Alcaraz, Gloria; Correa, Adriana

    2006-03-01

    An ethical analysis was performed during the development of a research project titled "Culture, nourishment and malaria in the Kuna aboriginals of Urabá, Colombia." This project had 2 objectives; (1) to investigate the prevalence of malaria and its relationship with hypovitaminosis A and nutritional status, and (2) to understand the community's conceptions and practices towards malaria. The current paper summarizes reflections concerning the application of ethical principles and moral values during the course of the malaria research project. Two intercultural relationships were clearly defined: the culture of the Tule (Kuna) Indians, with a traditional medical system, and the culture of the research group, focused on the biomedical model. The rationale and the discussion proposed during the writing of the project proposal was presented as well as the dilemmas that developed during the project within the communities. These problems required rapid decision-making in situations for which the scientists had not been adequately prepared. A need was indicated for application of ethical principles to permeate the analysis throughout the research process in a horizontal manner, such that the human dignity of the participants and the ethnicity of the community are preserved above the purposes of the project. In the research process, mediation between the ethics of conviction and the ethics of consequences must take precedence, with both outcomes tied to an informed consent in place during the process. The establishment of national and local research ethics committees was indicated as necessary to preserve the lifestyle and culture of the ethnic groups. These values were seen as endangered given the trading pressures and health policies in a globalized world. PMID:16929899

  2. Developing an Ethical Basis for Student-Teacher Interaction.

    ERIC Educational Resources Information Center

    Wehrwein, Teresa

    1996-01-01

    Nursing faculty must not only teach ethics to prospective nurses but also demonstrate it in relationships with students. Principles for ethical educational practice include mutual respect, open communication, boundary setting, consistent behaviors, and personal values. (SK)

  3. Ethics in publication.

    PubMed

    Wallace, Michael B; Siersema, Peter D

    2015-07-01

    Publication of scientific manuscripts remains our core method of sharing knowledge and advanced scientific inquiry. Pressures to publish for reasons other than pure discovery have the potential to corrupt this process. The core principles of scientific ethics outlined above provide guidance on how to maintain the integrity of our scientific process. We, as journal editors, are committed to the advancement of scientific knowledge and the ethical process of publication. We do the best we can to make sure that the articles we publish fulfill all the criteria of a well-conducted study. PMID:26099116

  4. Application of Software Design Principles and Debugging Methods to an Analgesia Prescription Reduces Risk of Severe Injury From Medical Use of Opioids

    Microsoft Academic Search

    SM Belknap; H Moore; SA Lanzotti; PR Yarnold; M Getz; DL Deitrick; A Peterson; J Akeson; T Maurer; RC Soltysik; GA Storm; I Brooks

    2008-01-01

    A prescription is a health-care program implemented by a physician or other qualified practitioner in the form of instructions that govern the plan of care for an individual patient. Although the algorithmic nature of prescriptions is axiomatic, this insight has not been applied systematically to medication safety. We used software design principles and debugging methods to create a “Patient-oriented Prescription

  5. Ethics Updates

    NSDL National Science Digital Library

    Hinman, Lawrence M.

    Created in 1994 by Professor Lawrence M. Hinman of the University of San Diego, the Ethics Updates site is designed primarily to be used to ethics instructors and their students. However, the site is rather interesting, so members of the general public may find themselves making a few return visits. Visitors can use the drop-down tabs on the top of the homepage to make their way through sections that cover some of the basic theories of ethics and also learn more about applied ethics in relation to such issues as animal rights, torture, and world hunger. Moving on, the "Resources" area includes case studies for discussion, a glossary of terms, classic texts in ethics, and ethics surveys. The site is rounded out by a search engine and a selection of videos that deal with various topics in ethics.

  6. Do Clinical Clerks Suffer Ethical Erosion? Students' Perceptions of Their Ethical Environment and Personal Development.

    ERIC Educational Resources Information Center

    Feudtner, Chris; And Others

    1994-01-01

    A survey of 665 fourth-year medical students in 6 schools investigated whether students had encountered ethically problematic situations, their attitudes about them, and their perceptions of their personal ethical development. Results suggest that ethical dilemmas are commonly encountered and often detrimental, warranting attention of physicians,…

  7. Antiprogestin drugs: ethical issues.

    PubMed

    Macklin, R

    1992-01-01

    Ethical issues of RU-486 in the US are the same as those of any new medical technology, but the politics of abortion can tempt us to believe that antiprogestins pose new ethical hazards. Good facts are needed to have good ethics. Risk-benefit assessments reveal medical facts and begin with clinical trials, evaluating RU-486's effectiveness and the degree and likelihood it causes harm, discomfort, and side effects. They should also consider social and psychological risks and benefits. Clinical trails in Los Angeles show that women who had previously undergone a surgical abortion method found RU-486 to be a less violent abortion method. Antiabortion proponents misconstrue this benefit to be a disadvantage, because they believe women undergoing abortion should suffer from pain and suffering. Even though an international convention ensures reproductive freedom for women, women must be informed about and have access to all family planning services in order to exercise this right. Ethics and the law require voluntary, informed consent. Yet, the US prevents workers at federally-funded family planning programs from providing clients any information on abortion, thereby violating this ethical requirement. Ethical precepts are also violated by denying women their right to privacy and by the punitive actions taken against women undergoing abortion by physicians, other health workers, and antiabortion proponents. Ru-486 allows women to undergo an abortion in private. Abortion opponents consider this privacy a disadvantage, because they lose targets for picketing, harassment, and violence. They believe that the improved access to abortion awarded by RU-486 would make abortion emotionally easier for women, leading to an increase in the number of abortions. Yet, there is no empirical evidence to support this. Again they see a benefit (decreased psychological stress) as a disadvantage. Ethical arguments show that RU-486 provides women greater health benefits, fosters their right to reproductive freedom, and improves the prospects for expanded social justice. PMID:1434763

  8. Taking ethical photos of children for medical and research purposes in low-resource settings: an exploratory qualitative study

    PubMed Central

    2013-01-01

    Background Photographs are commonly taken of children in medical and research contexts. With the increased availability of photographs through the internet, it is increasingly important to consider their potential for negative consequences and the nature of any consent obtained. In this research we explore the issues around photography in low-resource settings, in particular concentrating on the challenges in gaining informed consent. Methods Exploratory qualitative study using focus group discussions involving medical doctors and researchers who are currently working or have recently worked in low-resource settings with children. Results Photographs are a valuable resource but photographers need to be mindful of how they are taken and used. Informed consent is needed when taking photographs but there were a number of problems in doing this, such as different concepts of consent, language and literacy barriers and the ability to understand the information. There was no consensus as to the form that the consent should take. Participants thought that while written consent was preferable, the mode of consent should depend on the situation. Conclusions Photographs are a valuable but potentially harmful resource, thus informed consent is required but its form may vary by context. We suggest applying a hierarchy of dissemination to gauge how detailed the informed consent should be. Care should be taken not to cause harm, with the rights of the child being the paramount consideration. PMID:23835013

  9. Changes in medical student attitudes as they progress through a medical course.

    PubMed Central

    Price, J; Price, D; Williams, G; Hoffenberg, R

    1998-01-01

    OBJECTIVES: To explore the way ethical principles develop during a medical education course for three groups of medical students--in their first year, at the beginning of their penultimate (fifth) year and towards the end of their final (sixth) year. DESIGN: Survey questionnaire administered to medical students in their first, fifth and final (sixth) year. SETTING: A large medical school in Queensland, Australia. SURVEY SAMPLE: Approximately half the students in each of three years (first, fifth and sixth) provided data on a voluntary basis, a total of 385 students. RESULTS: At the point of entry, minor differences were found between medical students and first year law and psychology students. More striking were differences between male and female medical students, suggesting early socialization had a substantial impact here. CONCLUSIONS: Results indicate that substantial changes in attitude have developed by the beginning of fifth year with little change thereafter. Gender difference persisted. Some difference in ethical attitudes were found when groups of different ethnic backgrounds were compared. The impact of a move to a graduate medical course, which gives high priority to ethics within a professional development domain, can now be evaluated. PMID:9602998

  10. "Living in a Shell of Something I'm Not": Transsexuality, Medical Ethics, and the Judeo-Christian Culture.

    PubMed

    Wirth, Mathias

    2015-10-01

    A surgeon participating in a 2008 congress on the topic of trans-identified people posed the question of whether doctors would have to defend themselves when "judgment day" comes for having employed surgical means to turn men into women or vice versa? What might be viewed as a certain level of (medical) irrationality surrounding transgender life, coupled with widely documented cases of violence directed at these groups may well partly be attributable to the deeply internalized doctrine of creation in Judeo-Christian culture. Objections, however, to the use of transgender medicine "in the name of normalization" cannot relate to the biblical tradition, for there is no normative concept of gender and no text whose scope is to articulate theory of gender. In the vast expanse and freedom of the Judeo-Christian creator there is space for diversity, variations, and, above all, for the development of individual freedom. PMID:26156704

  11. Ethics and the treatment of sexual offenders.

    PubMed

    Mela, Mansfield; Ahmed, A G

    2014-06-01

    Clinicians in sex offender treatment programs always encounter the need to balance the best interests of sex offenders and the safety needs of the community. The protection of the community often takes primacy, resulting in violation of traditional mental health codes of ethics. These ethical dilemmas have generated debates in the academic community. To minimize ethical dilemmas, clinicians in sex offender treatment programs need to acknowledge the conflicts, adhere to safeguards, and thoughtfully address the challenges with profession-specific ethical values and codes. This article reviews ethical principles in relation to conceptualization of sex offenders and their assessment and treatment and research involving sex offenders. PMID:24877710

  12. Analysis of Case Consultations by an Ethics Committee

    E-print Network

    Murphy, Teresa A

    1987-01-01

    the ethics committee not getting back to nursing. In fact Iethics committee provides a means for better communication between the medical staff and nursingthe ethics committee. He said he supported the nursing staff

  13. Ethics in Science.

    PubMed

    Sharma, Om P

    2015-09-01

    Ethics are a set of moral principles and values a civilized society follows. Doing science with principles of ethics is the bedrock of scientific activity. The society trusts that the results and the projected outcome of any scientific activity is based on an honest and conscientious attempt by the scientific community. However, during the last few decades, there has been an explosion of knowledge and the advent of digital age. We can access the publications of competitors with just a "click". The evaluation parameters have evolved a lot and are based on impact factors, h-index and citations. There is a general feeling that the scientific community is under a lot of pressure for fulfilling the criteria for upward growth and even retention of the positions held. The noble profession of scientific research and academics has been marred by the temptation to falsify and fabricate data, plagiarism and other unethical practices. Broadly speaking, the breach of ethics involves: plagiarism, falsification of data, redundant (duplicate) publication, drawing far-fetched conclusions without hard data, for early publicity, gift authorship (receiving as well as giving), not giving sufficient attention and consideration to scholars and post-docs as per the norms, self promotion at the cost of team-members, treating colleagues (overall all juniors) in a feudal way and Machiavellianism (cunningness and duplicity in general conduct and push to positions of power and pelf). Misconduct in Indian academics and science is also under a lot of focus. It is important and urgent that science, engineering, and health departments and institutions in our country have in place systems for education and training in pursuit of science with ethics by sound and professional courses in Responsible Conduct of Research. All research and academic institution must have the Office of Ethics for information, guidelines, training and professional oversight of conduct of research with the ethos and ethics of research. PMID:26063945

  14. ETHICS IN GERIATRIC MEDICINE RESEARCH

    PubMed Central

    ?lgili, Önder; Arda, Berna; Munir, Kerim

    2014-01-01

    This article aims to evaluate the research process in geriatrics from the ethical point of view. The elderly population is increasing rapidly, but there is no parallel in the amount of research concerning this demographic. On the other hand, in the light of research ethics, this group mainly represents vulnerable people and requires more sensitivity. Taking into account all these features, fundamental principles in research ethics are first considered: the soundness of the scientific project, qualifications of the investigators, ethics committee approval, informed consent, confidentiality and privacy, beneficence/nonmaleficence, and justice are evaluated. Special ethical issues in geriatric research such as ageism and research inclusion, paucity of research involving elderly people, vulnerability of elderly subjects, and cognitive impairments are discussed separately. PMID:25489272

  15. Implant ethics

    PubMed Central

    Hansson, S

    2005-01-01

    Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal identity, and cultural effects. PMID:16131553

  16. Ethical principles and legal requirements for pediatric research in the EU: an analysis of the European normative and legal framework surrounding pediatric clinical trials

    Microsoft Academic Search

    Wim Pinxten; Kris Dierickx; Herman Nys

    2009-01-01

    The involvement of minors in clinical research is inevitable to catch up with the lack of drugs labeled for pediatric use.\\u000a To encourage the responsible conduct of pediatric clinical trials in the EU, an extensive legal framework has been developed\\u000a over the past decade in which the practical, ethical, legal, social, and commercial issues in pediatric research are addressed.\\u000a In

  17. The Ethics and Reality of Rationing in Medicine

    PubMed Central

    Scheunemann, Leslie P.

    2011-01-01

    Rationing is the allocation of scarce resources, which in health care necessarily entails withholding potentially beneficial treatments from some individuals. Rationing is unavoidable because need is limitless and resources are not. How rationing occurs is important because it not only affects individual lives but also expresses society’s most important values. This article discusses the following topics: (1) the inevitability of rationing of social goods, including medical care; (2) types of rationing; (3) ethical principles and procedures for fair allocation; and (4) whether rationing ICU care to those near the end of life would result in substantial cost savings. PMID:22147821

  18. Ethical Dilemmas and the Law

    Microsoft Academic Search

    Ira J. Kodner; Daniel M. Freeman; Robb R. Whinney; Douglas J. E. Schuerer

    \\u000a Professional responsibilities have been a concern of surgeons since antiquity; however, the last 25 years have displayed a\\u000a dramatic growth of both professional and societal attention to moral and ethical issues involved in the delivery of health\\u000a care. This increased interest in medical ethics has occurred because of such factors as the greater technological power of\\u000a modern medicine, the assigning

  19. Egocentric Ethics

    Microsoft Academic Search

    Nicholas Epley; Eugene M. Caruso

    2004-01-01

    Ethical judgments are often egocentrically biased, such that moral reasoners tend to conclude that self-interested outcomes are not only desirable but morally justifiable. Although such egocentric ethics can arise from deliberate self-interested reasoning, we suggest that they may also arise through unconscious and automatic psychological mechanisms. People automatically interpret their perceptions egocentrically, automatically evaluate stimuli on a semantic differential as

  20. "Ethics Shock."

    ERIC Educational Resources Information Center

    Knefelkamp, L. Lee

    1990-01-01

    Four books focusing on ethical issues in collegiate sports are reviewed: "Paterno by the Book,""Personal Fouls,""Never Too Young to Die: The Death of Len Bias," and "Rules of the Game: Ethics in College Sport." The themes of academic standards, student responsibility, the coach's role and responsibilities, the need for reform in college athletics…

  1. Ethical considerations in pediatric critical care research.

    PubMed

    Zeigler, Vicki L

    2011-06-01

    Pediatric critical care nurses are exposed to research in the critical care environment on a routine basis and should be knowledgeable about the ethical considerations inherent in this process. The following discussion includes information that centers on the ethical issues of conducting research with children. First, children as a vulnerable population is explored, followed by selected ethical principles that pertain to research, the role of the technological imperative in research, the process of informed consent, and finally, nursing considerations. PMID:21624697

  2. [Ethical aspects].

    PubMed

    Della Morte, E; Cappellano, F; Catanzaro, F

    1998-12-01

    The relation is considered between ethical choices, morals and deontology in plastic surgery of the male external genitals. Ethics dictates the behavioural model applied by an individual or group in their actions. Professional ethics--deontology--is the collection of duties governing the exercise of a certain profession. Morals are the set of rules governing an individual's life in society. Ethics, deontology and morals do not always convey the same message, since environmental, racial and religious situations, custom, and even fashion can influence a patient's demands, reflecting his desire to improve his quality of life, even only from the purely hedonistic viewpoint, and the specialist's attitude. Surgeons are increasingly tending to bend to these demands or--much worse--even encourage and foster them, with a view to financial considerations. The attitude and ethical choices available are examined in relation to surgery to lengthen or enlarge the penis. PMID:9882901

  3. Metrological Reliability of Medical Devices

    NASA Astrophysics Data System (ADS)

    Costa Monteiro, E.; Leon, L. F.

    2015-02-01

    The prominent development of health technologies of the 20th century triggered demands for metrological reliability of physiological measurements comprising physical, chemical and biological quantities, essential to ensure accurate and comparable results of clinical measurements. In the present work, aspects concerning metrological reliability in premarket and postmarket assessments of medical devices are discussed, pointing out challenges to be overcome. In addition, considering the social relevance of the biomeasurements results, Biometrological Principles to be pursued by research and innovation aimed at biomedical applications are proposed, along with the analysis of their contributions to guarantee the innovative health technologies compliance with the main ethical pillars of Bioethics.

  4. Ethical Realism: A Guide to Action?

    ERIC Educational Resources Information Center

    Matkin, Gary

    2008-01-01

    This article presents the author's response to Gary Miller's essay entitled "Ethical Realism and Continuing Education." In his essay, Dr. Miller has provided a valuable opportunity to reflect on the practice of continuing education (CE) leadership. Dr. Miller reviews six principles that are encapsulated in the concept of ethical realism, but are…

  5. Business Ethics: Too Little, Too Late.

    ERIC Educational Resources Information Center

    Macfarlane, Bruce

    1995-01-01

    Typical business ethics courses conform to a rationale demonstrating market benefits of ethical behavior rather than encouraging examination of the assumptions and effects of business practice. They tend to reinforce free-market principles and encourage students to regard business as distinct from society. (SK)

  6. The Ethics of Social Work Supervision Revisited.

    ERIC Educational Resources Information Center

    Cohen, Ben-Zion

    1987-01-01

    Charles Levy's classic 1973 article outlined a set of basic value-orientations for supervisors. Attempts to operationalize Levy's principles in order to develop practical guidelines for ethical practice. Discusses problem of "careerism" in social worker supervisors. Recommends supervisors examine ethical implications of their behavior. (Author/ABL)

  7. Interrelationship of ecological science and environmental ethics

    Microsoft Academic Search

    Marietta; D. E. Jr

    2009-01-01

    A recent trend among environmentalists (e.g., Aldo Leopold) of basing ethical norms for land use, resource management and conservation on eological principles such as homeostasis is examined. Justification for such an ethical approach through analysis of moral judgment in explored and argued to be as sound as more traditional approaches. Issues such as the is\\/ought impasse, the connection between value

  8. The Role of Positive Ethics and Virtues in the Context of Sport and Performance Psychology Service Delivery

    Microsoft Academic Search

    Mark W. Aoyagi; Steven T. Portenga

    2010-01-01

    Ethical principles developed for clinical\\/counseling psychologists are a useful, but incomplete, guide for sport and performance psychology (SPP) practitioners. Positive and virtue ethics are introduced to the SPP ethical literature as an additional resource. Positive ethics focus on practitioners' reaching their fullest potential rather than avoiding risk (Knapp & VanDeCreek, 2006). Virtue ethics emphasize the character of the professional rather

  9. Body art and medical need

    PubMed Central

    Brassington, I

    2006-01-01

    A company called Biojewellery has proposed to take a sample of bone tissue from a couple and to grow this sample into wedding rings. One of the ethical problems that such a proposal faces is that it implies surgery without medical need. To this end, only couples with a prior need for surgery are being considered. This paper examines the question of whether such a stipulation is necessary. It is suggested that, though medical need and the provision of health and wellbeing is overwhelmingly the warrant for surgical intervention, there is no reason in principle why other, non?medical, projects such as jewellery creation might not also warrant surgical intervention. Implicitly, this line of thought forces us to consider the proper place of surgical intervention—that is, to ask what surgeons are for. PMID:16373516

  10. School Counselor Advocacy: When Law and Ethics May Collide

    ERIC Educational Resources Information Center

    Stone, Carolyn B.; Zirkel, Perry A.

    2010-01-01

    Legal rules establish basic duties akin to the floor for acceptable behavior, whereas ethical codes represent aspirational standards for best practice. For school counselors, fulfilling both legal requirements and ethical principles may pose challenges that warrant careful consideration. This article outlines a legal/ethical conflict in the case…

  11. Ethical Issues of Scientific Inquiry in Health Science Education.

    ERIC Educational Resources Information Center

    Pigg, R. Morgan, Jr., Ed.

    1994-01-01

    This monograph contains 13 papers on the ethics of planning, conducting, and reporting research in health sciences education. It includes four background papers and nine perspective papers. The titles are: (1) "The Imperative for Ethical Conduct in Scientific Inquiry" (Steve M. Dorman); (2) "Fundamental Principles of Ethical Research in Health…

  12. Benefit - a neglected aspect of health research ethics

    Microsoft Academic Search

    Maria Vang Johansen; Jens Aagaard-Hansen; Povl Riis

    2008-01-01

    In research ethics, provision of potential benefits to study participants is linked to the principles of beneficence and distributive justice. However, in most research ethical codes the notion of benefit is only superficially elabor- ated which is extended in vague and general benefit assessments in research proposals and in Research Ethical Committee's (REC) recommendations. The issue gains additional importance in

  13. Doing the Right Thing: Ethical Issues in Higher Education

    ERIC Educational Resources Information Center

    Couch, Sue

    2005-01-01

    Recent ethical lapses in corporate America have motivated institutions of higher education to focus more attention on their ethical responsibilities. These responsibilities include creating ethical learning environments in which students can learn the principles and traditions of professional practice and develop knowledge and skills to help them…

  14. Using Gaming To Help Nursing Students Understand Ethics.

    ERIC Educational Resources Information Center

    Metcalf, Barbara L.; Yankou, Dawn

    2003-01-01

    An ethics game involves nursing students in defending actions in ethics-based scenarios. Benefits include increased confidence, ability to see multiple perspectives, values clarification, and exposure to decision-making models, professional responsibilities, ethical principles, social expectations, and legal requirements. Difficulties include…

  15. Background Reading: Ethical Perspectives and Theories

    NSDL National Science Digital Library

    2008-01-01

    This resource is a PDF that provides short background reading describing values, morals, and ethics, as well as these perspectives: Moral Rules and Duties, Outcomes, Virtues, Principles, and Care/Feminist.

  16. Ethics and Research Priorities in Academic Administration.

    ERIC Educational Resources Information Center

    Yeaworth, Rosalee C.

    1997-01-01

    Reviews macro and micro issues in determining research priorities for nursing education. Illustrates how decisions can be shaped by such ethical principles as caring, utility, justice, and faithfulness. Considers distributive justice as a guide for resource allocation. (SK)

  17. Ethics (lesson)

    NSDL National Science Digital Library

    2009-04-14

    Students examine some examples of ethical issues that have resulted from our expanded knowledge of neuroscience. They are asked to write a position paper describing their own point of view on one of these controversial topics.

  18. Can hospital promotional activities be more ethical?

    PubMed

    Chen, Yiyi; Yin, Zhou; Xie, Qiong; Shao, Zhexin

    2014-05-01

    At present, there exist a lot of violations of medical ethics in advertising and promotional activities, which have been infringing the rights of patients. Therefore, the ethical criteria should be established as soon as possible to regulate the hospital promotional activities, to regain the trust of people. PMID:24948998

  19. Primer on Ethics and Crossing Species Boundaries

    NSDL National Science Digital Library

    Fran�§oise Baylis and Jason Scott Robert (Dalhousie University and Arizona State University; )

    2006-05-01

    When you cross species boundaries, you combine the genetic or cellular material of two species. This peer-reviewed issue oriented article addresses whether it is ethical to experiment with part-human animals? Do the potential medical benefits outweigh the ethical concerns? Should guidelines be constructed for such research? How far should science go in pursuit of knowledge?

  20. Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.

    PubMed

    Boutin-Foster, Carla; Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

    2013-12-01

    Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings. PMID:24134347

  1. Ethical Considerations for Conducting Health Disparities Research in Community Health Centers: A Social-Ecological Perspective

    PubMed Central

    Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

    2013-01-01

    Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings. PMID:24134347

  2. Human Participants in Engineering Research: Notes from a Fledgling Ethics Committee.

    PubMed

    Koepsell, David; Brinkman, Willem-Paul; Pont, Sylvia

    2015-08-01

    For the past half-century, issues relating to the ethical conduct of human research have focused largely on the domain of medical, and more recently social-psychological research. The modern regime of applied ethics, emerging as it has from the Nuremberg trials and certain other historical antecedents, applies the key principles of: autonomy, respect for persons, beneficence, non-maleficence, and justice to human beings who enter trials of experimental drugs and devices (Martensen in J Hist Med Allied Sci 56(2):168-175, 2001). Institutions such as Institutional Review Boards (in the U.S.) and Ethics Committees (in Europe and elsewhere) oversee most governmentally-funded medical research around the world, in more than a hundred nations that are signers of the Declaration of Helsinki (World Medical Association 2008). Increasingly, research outside of medicine has been recognized to pose potential risks to human subjects of experiments. Ethics committees now operate in the US, Canada, the U.K. and Australia to oversee all governmental-funded research, and in other jurisdictions, the range of research covered by such committees is expanding. Social science, anthropology, and other fields are falling under more clear directives to conduct a formal ethical review for basic research involving human participants (Federman et al. in Responsible research: a systems approach to protecting research participants. National Academies Press, Washington, 2003, p. 36). The legal and institutional response for protecting human subjects in the course of developing non-medical technologies, engineering, and design is currently vague, but some universities are establishing ethics committees to oversee their human subjects research even where the experiments involved are non-medical and not technically covered by the Declaration of Helsinki. In The Netherlands, as in most of Europe, Asia, Latin America, or Africa, no laws mandate an ethical review of non-medical research. Yet, nearly 2 years ago we launched a pilot ethics committee at our technical university and began soliciting our colleagues to submit their studies for review. In the past year, we have become officially recognized as a human subjects ethics committee for our university and we are beginning the process of requiring all studies using human subjects to apply for our approval. In this article, we consider some of the special problems relating to protecting human participants in a technology context, and discuss some of our experiences and insights about reviewing human subjects research at a technical university, concluding: that not less than in medical studies, human participants used in technology research benefit from ethical committees' reviews, practical requirements for publications, grants, and avoiding legal liability are also served by such committees, and ethics committees in such contexts have many similarities to, but certain other special foci than medical ethics committees. We believe that this experience, and these observations, are helpful for those seeking to establish such committees in technology research contexts, and for framing the particular issues that may arise in such contexts for the benefit of researchers, and nascent committees seeking to establish their own procedures. PMID:24938695

  3. Research ethics and private harms.

    PubMed

    Koocher, Gerald P

    2014-12-01

    This commentary addresses the emotionally powerful account of Nicole Taus Kluemper from the perspective of a psychologist familiar with the administrative operation of the American Psychological Association (APA) and the ethics of the profession. The application of the APA's Ethical Principles of Psychologists and Code of Conduct to the case is discussed, and alternative methods of response that researchers who have concerns about case studies might use are offered. The author concludes that existing ethical principles-the aspirational standards in particular-do bear upon the matter in question. However, the enforceable code of conduct is not sufficiently clear about obligations to those whom psychologists publicly discuss when the psychologist does not have a specific duty of care to an individual. PMID:24870964

  4. Ethical dilemmas and professional roles in occupational medicine

    Microsoft Academic Search

    Sue Gena Lurie

    1994-01-01

    Occupational medicine presents ethical dilemmas between worker health and corporate goals, for both physicians and managers. Physicians in occupational practice recognize conflict between 'moralist' and 'utilitarian' ethical positions. This paper analyzes the relation of professional roles to ethical interpretations by occupational physicians, based on their own and medical ethicists' formulations of dilemmas. Physicians' conflicting responsibilities to workers as patients and

  5. Do Editorial Policies Support Ethical Research? A Thematic Text Analysis of Author Instructions in Psychiatry Journals

    PubMed Central

    Strech, Daniel; Metz, Courtney; Knüppel, Hannes

    2014-01-01

    Introduction According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal’s instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. Methods and Findings The information given on ethics review and informed consent and the mentioning of the ICMJE and COPE recommendations were assessed within author’s instructions and online submission procedures of all 123 eligible psychiatry journals. While 54% and 58% of editorial policies required ethics review and informed consent, only 14% and 19% demanded the reporting of these issues in the manuscript. The TOP-10 psychiatry journals (ranked by impact factor) performed similarly in this regard. Conclusions Only every second psychiatry journal adheres to the ICMJE’s recommendation to inform authors about requirements for informed consent and ethics review. Furthermore, we argue that even the ICMJE’s recommendations in this regard are insufficient, at least for ethically challenging clinical trials. At the same time, ideal scientific design sometimes even needs to be compromised for ethical reasons. We suggest that features of clinical studies that make them morally controversial, but not necessarily unethical, are analogous to methodological limitations and should thus be reported explicitly. Editorial policies as well as reporting guidelines such as CONSORT should be extended to support a meaningful reporting of ethical research. PMID:24901366

  6. Practical guidance for charting ethics consultations.

    PubMed

    Bruce, Courtenay R; Smith, Martin L; Tawose, Olubukunola Mary; Sharp, Richard R

    2014-03-01

    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients' medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation. PMID:24126950

  7. Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents.

    ERIC Educational Resources Information Center

    Swann, Stephanie; Herbert, Sarah E.

    1999-01-01

    Examines ethical dilemmas arising when treating adolescents with gender dysphoria, discussing ethical and legal issues pertinent to treating any adolescent and highlighting gender dysphoric adolescents. Reviews legal decisions, existing data on adolescent decision making, and ethical principles for resolving complex situations. Illustrates ethical

  8. Ethics Committees in the Rural Midwest: Exploring the Impact of HIPAA

    ERIC Educational Resources Information Center

    Having, Karen M.; Hale, Dena; Lautar, Charla J.

    2008-01-01

    Context: Confidentiality of personal health information is an ethical principle and a legislated mandate; however, the impact of the Health Insurance Portability and Accountability Act (HIPAA) on ethics committees ethics committees is limited. Purpose: This study investigates the prevalence, activity, and composition of ethics committees located…

  9. The Ethical Implications of the Five-Stage Skill-Acquisition Model

    ERIC Educational Resources Information Center

    Dreyfus, Hubert L.; Dreyfus, Stuart E.

    2004-01-01

    We assume that acting ethically is a skill. We then use a phenomenological description of five stages of skill acquisition to argue that an ethics based on principles corresponds to a beginner's reliance on rules and so is developmentally inferior to an ethics based on expert response that claims that, after long experience, the ethical expert…

  10. Practical virtue ethics: healthcare whistleblowing and portable digital technology.

    PubMed

    Bolsin, S; Faunce, T; Oakley, J

    2005-10-01

    Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development. PMID:16199607

  11. The ethical problem of randomization.

    PubMed

    Colli, Agostino; Pagliaro, Luigi; Duca, Piergiorgio

    2014-10-01

    The Fondazione Umberto Veronesi ethics committee recently published a statement concerning the inherent ethical issues of randomized clinical trials (RCTs), mainly focusing on randomization, raising many questions, and suggesting possible solutions. The main concern is that the patients enrolled in a RCT are used to improve medical knowledge, but they cannot be the beneficiaries of the results of the trials in which they are participating. Possible solutions come from a wider use of clinical and administrative databases, and an early termination of trials. We discuss this statement, emphasizing that the scientific and ethical reason for embarking on a clinical trial is uncertainty. The uncertainty regarding the comparative benefits and harms of each compared treatment (clinical equipoise) warrants equity in allocation. Randomization allows one to obtain unbiased evidence that we cannot know in advance. The expected probability of a new treatment to be successful describes the limits within which a study can be acceptable both from an ethical as well as a scientific point of view. Most people accept enrollment in a RCT if the probability of success of the experimental treatment is between 50 and 70%. The assumption and concern that there is a conflict between "scientific" and "ethical" aspects of a clinical trial due to randomization should at least be mitigated, considering that only scientifically sounded studies can be considered ethical. Randomization remains the appropriate approach to ensure the study's internal validity. Different aspects seem to be more important, from the ethical point of view, considering RCT and their publication. PMID:25194693

  12. Normative Sentimentalism and Animal Ethics

    E-print Network

    Gerrek, Monica

    2008-01-09

    The purpose of this dissertation is to present what I think is a particularly compelling normative version of sentimentalism. The moral principle which is the foundation of this ethic is: An act, or a failure to act, is morally wrong if and only...

  13. The commodification of medical and health care: the moral consequences of a paradigm shift from a professional to a market ethic.

    PubMed

    Pellegrino, E D

    1999-06-01

    Commodification of health care is a central tenet of managed care as it functions in the United States. As a result, price, cost, quality, availability, and distribution of health care are increasingly left to the workings of the competitive marketplace. This essay examines the conceptual, ethical, and practical implications of commodification, particularly as it affects the healing relationship between health professionals and their patients. It concludes that health care is not a commodity, that treating it as such is deleterious to the ethics of patient care, and that health is a human good that a good society has an obligation to protect from the market ethos. PMID:10472814

  14. 716 journal of law, medicine & ethics Recommendations

    E-print Network

    Kokkoli, Efie

    716 journal of law, medicine & ethics Recommendations for Nanomedicine Human Subjects Research and in vivo nanodiagnostics are a subset of nanomedicine applications that includes drugs, biologi- cal products, and implantable medical devices incorporat- ing nanoscale materials.These nanomedicine products

  15. Statistics and Ethics in Surgery and Anesthesia

    ERIC Educational Resources Information Center

    Gilbert, John P.; And Others

    1977-01-01

    Analyzes 46 medical research papers on the effects of innovative versus standard surgical procedures on the health of patients. Results reveal that innovations generally reduce complications. The ethics of experimental surgery are also discussed. (CP)

  16. Treating an HIV/AIDS Patient's PTSD and Medication Nonadherence with Cognitive-Behavioral Therapy: A Principle-Based Approach

    ERIC Educational Resources Information Center

    Chernoff, Robert A.

    2007-01-01

    HIV/AIDS patients with medication adherence problems are vulnerable to developing drug resistance, immune system degradation, and opportunistic infections. Poor adherence to antiretroviral medication regimens can be aggravated by psychiatric problems, including depression and posttraumatic stress disorder. This article presents the case study of a…

  17. Research Ethics: Institutional Review Board Oversight of Art Therapy Research

    ERIC Educational Resources Information Center

    Deaver, Sarah P.

    2011-01-01

    By having their research proposals reviewed and approved by Institutional Review Boards (IRBs), art therapists meet important ethical principles regarding responsibility to research participants. This article provides an overview of the history of human subjects protections in the United States; underlying ethical principles and their application…

  18. Professional Ethics for Climate Scientists

    NASA Astrophysics Data System (ADS)

    Peacock, K.; Mann, M. E.

    2014-12-01

    Several authors have warned that climate scientists sometimes exhibit a tendency to "err on the side of least drama" in reporting the risks associated with fossil fuel emissions. Scientists are often reluctant to comment on the implications of their work for public policy, despite the fact that because of their expertise they may be among those best placed to make recommendations about such matters as mitigation and preparedness. Scientists often have little or no training in ethics or philosophy, and consequently they may feel that they lack clear guidelines for balancing the imperative to avoid error against the need to speak out when it may be ethically required to do so. This dilemma becomes acute in cases such as abrupt ice sheet collapse where it is easier to identify a risk than to assess its probability. We will argue that long-established codes of ethics in the learned professions such as medicine and engineering offer a model that can guide research scientists in cases like this, and we suggest that ethical training could be regularly incorporated into graduate curricula in fields such as climate science and geology. We recognize that there are disanalogies between professional and scientific ethics, the most important of which is that codes of ethics are typically written into the laws that govern licensed professions such as engineering. Presently, no one can legally compel a research scientist to be ethical, although legal precedent may evolve such that scientists are increasingly expected to communicate their knowledge of risks. We will show that the principles of professional ethics can be readily adapted to define an ethical code that could be voluntarily adopted by scientists who seek clearer guidelines in an era of rapid climate change.

  19. Incorporating global components into ethics education.

    PubMed

    Wang, George; Thompson, Russell G

    2013-03-01

    Ethics is central to science and engineering. Young engineers need to be grounded in how corporate social responsibility principles can be applied to engineering organizations to better serve the broader community. This is crucial in times of climate change and ecological challenges where the vulnerable can be impacted by engineering activities. Taking a global perspective in ethics education will help ensure that scientists and engineers can make a more substantial contribution to development throughout the world. This paper presents the importance of incorporating the global and cross culture components in the ethic education. The authors bring up a question to educators on ethics education in science and engineering in the globalized world, and its importance, necessity, and impendency. The paper presents several methods for discussion that can be used to identify the differences in ethics standards and practices in different countries; enhance the student's knowledge of ethics in a global arena. PMID:21769592

  20. Between same-sex marriages and the Large Hadron Collider: making sense of the precautionary principle.

    PubMed

    Petrenko, Anton; McArthur, Dan

    2010-09-01

    The Precautionary Principle is a guide to coping with scientific uncertainties in the assessment and management of risks. In recent years, it has moved to the forefront of debates in policy and applied ethics, becoming a key normative tool in policy discussions in such diverse areas as medical and scientific research, health and safety regulation, environmental regulation, product development, international trade, and even judicial review. The principle has attracted critics who claim that it is fundamentally incoherent, too vague to guide policy, and makes demands that are logically and scientifically impossible. In this paper we will answer these criticisms by formulating guidelines for its application that ensure its coherence as a useful normative guide in applied and policy ethics debates. We will also provide analyses of cases that demonstrate how our version of the principle functions in practice. PMID:19757190

  1. Ethics in dermatology: toward a new paradigm.

    PubMed

    López-Martín, S; Galera-Martin, C; Guerra-Tapia, A

    2013-01-01

    Medical ethics have evolved over time, and ethical responsibilities have often been shared by priests, the governing classes, and physicians. The emergence of scientific medicine led to the separation of functions, yet physicians have nonetheless continued to enjoy an extraordinary degree of moral authority and great social privilege. From this starting point, professional medical ethics developed as a specific moral system based on special rights and duties (paternalism and medical confidentiality). Various historical events brought this longstanding situation to a point of crisis toward the middle of the 20th century, and for several decades since, medical ethics have been based on freedom of choice for the patient with regard to decisions about his or her own body and health. Recent developments have created a new, still poorly defined model that takes into consideration such matters as euthanasia, abortion, provision of information on the benefits and harm of treatments, the sharing of therapeutic decision-making with the patient and/or family members, the choice of public or private medical providers, therapeutic guidelines, and the extension of the scope of practice to include preventive measures and cosmetic procedures. What is needed now is a new ethical system for plural societies that harbor different religions, beliefs and lifestyles, but that is also rational, universal and subject to ongoing revision-a system always striving for scientific, technical and moral excellence. Such an ethical system would have to be taught in medical schools, as it would need to bear fruit beyond mere good intentions. PMID:22944290

  2. The Muslim Physician and the Ethics of Medicine

    PubMed Central

    Arawi, Thalia A.

    2010-01-01

    Virtuous physicians seem to have become a rarity in modern day medical practice. Many patients and physicians feel that the profession of medicine is not living up to its own standards and expectations. It is the contention of the author that the Muslim physician, guided by the two primary sources of Islamic Law, the Qur’an and the Sunna, will possess the necessary character traits of a good physician. In this article I argue that the Muslim physician who abides by the Qur’an will live a contented life, will be trusted by his/her patients and community, and will be in line with the recently enacted Western principles of medical ethics. PMID:23864762

  3. Dilemmas, ethics and intent--a commentary.

    PubMed

    Downie, Robin S

    1986-12-01

    Responding to a preceding article by Michael J. Newton ("Moral dilemmas in surgical training: intent and the case for ethical ambiguity"), Downie comments on three of Newton's themes. He agrees that trainees should engage in ethical self-appraisal but cautions that introspection is inappropriate at the time of an operation. Regarding Newton's downplaying of philosophical analysis in medical ethics, Downie agrees that there are limitations to the philosophical approach but contends that it can serve a very worthwhile function in helping doctors deal with ethical uncertainties. Finally, Downie perceives ambiguities in Newton's emphasis on the central importance of "ethical intent," which rejects the idea of ethical standards while urging individuals to take "personal responsibility" for their actions. PMID:11643948

  4. Ethical issues faced by nursing editors.

    PubMed

    Freda, Margaret Comerford; Kearney, Margaret H

    2005-06-01

    This study reports on ethical issues faced by editors of nursing journals, a topic which has not appeared in the nursing literature. A survey of nursing editors (n = 88)was conducted via e-mail; this article is the content analysis of survey questions about ethics. Eight categories of ethical issues emerged: problems with society/association/publisher; decisions about inflammatory submissions; informed consent or IRB issues; conflicts of interest; advertising pressures; duplicate publications and/or plagiarism; difficult interactions with authors; and authorship. Some issues were similar to those published about medical editors; however, others were unique. This study can assist authors to better understand some of the ethical issues in publishing, can help editors to view their issues in the context of what others experience, and can assist societies and publishers to work toward avoiding these ethical issues in the future. Professional discussions about ethics in nursing publications should be the subject of ongoing research and scientific inquiry. PMID:15870245

  5. Organ Transplantation: Legal, Ethical and Islamic Perspective in Nigeria

    PubMed Central

    Bakari, Abubakar A; Abbo Jimeta, Umar S; Abubakar, Mohammed A; Alhassan, Sani U; Nwankwo, Emeka A

    2012-01-01

    Organ transplantation dates back to the ancient times and since then it has become one of the important developments in modern medicine; saving the lives, as well as improving the quality of life of many patients. As the demand for organ transplantation far exceeds the organ availability, the transplant program is often saddled with complex legal and ethical issues. This review article highlights the legal and ethical issues that might arise regarding organ transplantation and appraises the existing legal frame work governing organ transplantation in Nigeria. Information on legal, cultural, religious and medical ethical issues regarding organ transplantation in Nigeria was obtained by searching the PubMed and Google Scholar, conference proceedings, seminar paper presentations, law library and other related publications were collated and analyzed. In decision making for organ transplantation, the bioethical principles like autonomy, beneficence and justice must be employed. It was believed by Catholic theologians that to mutilate one living person to benefit another violates the principle of Totality. Among Muslim scholars and researchers, there are those who throw legal support as to its permissibility while the other group sees it as illegal. Organ/tissues transplantation is considered a medical intervention that touches on the fundamental rights of the donor or the recipient. Where there is an unlawful infringement of the right of such persons in any way may be regarded as against Section 34 of the 1999 Nigerian Constitution dealing with right to dignity of the human person. Worldwide, the researchers and government bodies have agreed on informed consent for organ/tissue donation and for recipient should be obtained without coercion before embarking on such medical treatment Worldwide organ transplantation has become the best medical treatment for patients with end stage organ failure. However, there is no law/legislation backing organ/tissues transplantation in Nigeria. The government should take measures to combat transplantation tourism and the problem of national and international trafficking in human tissues and organs, ethics commission and National Transplant registry should be established in order to monitor and regulate the programme in the country. PMID:24027394

  6. Media debates and 'ethical publicity' on social sex selection through preimplantation genetic diagnosis (PGD) technology in Australia.

    PubMed

    Whittaker, Andrea

    2015-09-01

    This paper offers a critical discourse analysis of media debate over social sex selection in the Australian media from 2008 to 2014. This period coincides with a review of the National Health and Medical Research Council's Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research (2007), which underlie the regulation of assisted reproductive clinics and practice in Australia. I examine the discussion of the ethics of pre-implatation genetic diagnosis (PGD) within the media as 'ethical publicity' to the lay public. Sex selection through PGD is both exemplary of and interconnected with a range of debates in Australia about the legitimacy of certain reproductive choices and the extent to which procreative liberties should be restricted. Major themes emerging from media reports on PGD sex selection in Australia are described. These include: the spectre of science out of control; ramifications for the contestation over the public funding of abortion in Australia; private choices versus public authorities regulating reproduction; and the ethics of travelling overseas for the technology. It is concluded that within Australia, the issue of PGD sex selection is framed in terms of questions of individual freedom against the principle of sex discrimination - a principle enshrined in legislation - and a commitment to publically-funded medical care. PMID:25803702

  7. Medical marijuana: medical necessity versus political agenda.

    PubMed

    Clark, Peter A; Capuzzi, Kevin; Fick, Cameron

    2011-12-01

    Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912

  8. Medical marijuana: Medical necessity versus political agenda

    PubMed Central

    Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron

    2011-01-01

    Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government’s stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912

  9. Medical tourism: between entrepreneurship opportunities and bioethics boundaries: narrative review article.

    PubMed

    Badulescu, Daniel; Badulescu, Alina

    2014-04-01

    Nowadays, medical tourism reports impressive growth in terms of number of persons, income and number of countries involved in cross-border flows. So this study was undertaken to clarify entrepreneurship opportunities and bio-ethics boundaries in medical tourism. For tourism entrepreneurs, these outgoing flows related to medical procedures and tourism become an opportunity that cannot be ignored, so a wide range of tourist services related to health care are provided on a private, entrepreneurial basis. However, social and economic boundaries are omnipresent (impaired health services in receiving (incoming) countries, the crisis of the health care systems in emitting (outgoing) countries, over-consumption of medical and tourism services), and, not least, ethical considerations. Transforming medical care in a market tool, reducing human attributes to the status of commodity that can be bought, sold or negotiated, seriously challenges contemporary bioethics principles. It is a significant entering in the area (which is essentially un-ethic) of market transactions, where libertarianism and consumer-oriented attitudes dominates the spectrum of rational choice. So tourism comes to provide an organized and comfortable framework for all these choices, but many issues still re-main controversial and may worsen if national health systems and national and international regulations would not identify their problems and would continue to leave medical tourism to market mechanisms. Market will efficiently allocate the resources, but not always in an ethical manner. PMID:26005650

  10. Development and preliminary evidence for the validity of an instrument assessing implementation of human-factors principles in medication-related decision-support systems—I-MeDeSA

    PubMed Central

    Zachariah, Marianne; Seidling, Hanna M; Neri, Pamela M; Cresswell, Kathrin M; Duke, Jon; Bloomrosen, Meryl; Volk, Lynn A; Bates, David W

    2011-01-01

    Background Medication-related decision support can reduce the frequency of preventable adverse drug events. However, the design of current medication alerts often results in alert fatigue and high over-ride rates, thus reducing any potential benefits. Methods The authors previously reviewed human-factors principles for relevance to medication-related decision support alerts. In this study, instrument items were developed for assessing the appropriate implementation of these human-factors principles in drug–drug interaction (DDI) alerts. User feedback regarding nine electronic medical records was considered during the development process. Content validity, construct validity through correlation analysis, and inter-rater reliability were assessed. Results The final version of the instrument included 26 items associated with nine human-factors principles. Content validation on three systems resulted in the addition of one principle (Corrective Actions) to the instrument and the elimination of eight items. Additionally, the wording of eight items was altered. Correlation analysis suggests a direct relationship between system age and performance of DDI alerts (p=0.0016). Inter-rater reliability indicated substantial agreement between raters (?=0.764). Conclusion The authors developed and gathered preliminary evidence for the validity of an instrument that measures the appropriate use of human-factors principles in the design and display of DDI alerts. Designers of DDI alerts may use the instrument to improve usability and increase user acceptance of medication alerts, and organizations selecting an electronic medical record may find the instrument helpful in meeting their clinicians' usability needs. PMID:21946241

  11. Ethical community-engaged research: a literature review.

    PubMed

    Mikesell, Lisa; Bromley, Elizabeth; Khodyakov, Dmitry

    2013-12-01

    Health research has relied on ethical principles, such as those of the Belmont Report, to protect the rights and well-being of research participants. Community-based participatory research (CBPR), however, must also consider the rights and well-being of communities. This requires additional ethical considerations that have been extensively discussed but not synthesized in the CBPR literature. We conducted a comprehensive thematic literature review and summarized empirically grounded discussions of ethics in CBPR, with a focus on the value of the Belmont principles in CBPR, additional essential components of ethical CBPR, the ethical challenges CBPR practitioners face, and strategies to ensure that CBPR meets ethical standards. Our study provides a foundation for developing a working definition and a conceptual model of ethical CBPR. PMID:24134352

  12. Ethical Challenges

    ERIC Educational Resources Information Center

    Morris, Michael

    2005-01-01

    The Ethical Challenges scenario in the June 2004 issue of the American Journal of Evaluation focused on an evaluator-client disagreement concerning the wisdom of having consumer representation on a steering committee that would help plan and oversee an evaluation in an agency providing community-based residential services to the chronically…

  13. Are ethical theories relevant for ethical leadership?

    Microsoft Academic Search

    Michel Dion

    2012-01-01

    Purpose – The aim of this study is to know if ethical theories could be connected to some leadership approaches. Design\\/methodology\\/approach – In the paper eight leadership approaches are selected: directive leadership, self-leadership, authentic leadership, transactional leadership, shared leadership, charismatic leadership, servant leadership, transformational leadership. Five western ethical theories (philosophical egoism, utilitarianism, Kantianism, ethics of virtue, ethics of responsibility) are

  14. When Ethics Survive Where People Do Not

    PubMed Central

    Hussein, Ghaiath M. A.

    2010-01-01

    The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? PMID:20336229

  15. Hospital ethics committees in Israel: structure, function and heterogeneity in the setting of statutory ethics committees

    PubMed Central

    Wenger, N; Golan, O; Shalev, C; Glick, S

    2002-01-01

    Objectives: Hospital ethics committees increasingly affect medical care worldwide, yet there has been little evaluation of these bodies. Israel has the distinction of having ethics committees legally required by a Patients' Rights Act. We studied the development of ethics committees in this legal environment. Design: Cross-sectional national survey of general hospitals to identify all ethics committees and interview of ethics committee chairpersons. Setting: Israel five years after the passage of the Patients' Rights Act. Main measurements: Patients' rights and informal ethics committee structure and function. Results: One-third of general hospitals have an ethics committee, with committees concentrated in larger facilities. Hospitals without committees tended to lack any structure to handle ethics issues. Committees tend to be interdisciplinary and gender-mixed but ethnic mix was poor. Confidentiality is the rule, however, legal liability is a concern. One-third of patients' rights ethics committees never convened and most committees had considered fewer than ten consults. Access to the consultation process and the consultation process itself varied substantially across committees. Some patients' rights ethics committees attempted to solve cases, others only rendered decisions. Informal committees often refused to consider cases within Patients' Rights Act jurisdiction. Conclusions: Despite statutory requirement, many Israeli patients and clinicians do not have access to ethics committees. The scant volume of cases shows serious discrepancies between practice and Patients' Rights Act regulations, suggesting the need for education or revision of the law. Heterogeneity in committee function demonstrates need for substantial improvement. PMID:12042404

  16. The evolving approach to ethical issues in living donor kidney transplantation: a review based on illustrative case vignettes.

    PubMed

    Venkat, K K; Eshelman, Anne K

    2014-07-01

    Living donor kidney transplantation which involves performing a major surgical procedure on a healthy person solely to benefit another person has always involved dealing with difficult ethical issues. Beneficence, non-maleficence, donor autonomy, altruistic donor motivation, coercion-free donation, fully informed consent and avoidance of medical paternalism have been the dominant ethical principles governing this field ever since the first successful living donor kidney transplant in 1954. The increasing reliance on living donors due to the rapidly growing disparity between the number of patients awaiting transplantation and the availability of deceased donor kidneys has brought with it a variety of new ethical issues of even greater complexity. Issues such as confidentiality of donor and recipient medical information, the appropriateness of the invented medical excuse to avoid donation and the approach to misattributed paternity discovered during work-up for living donor transplantation have made the information to be disclosed prior to obtaining donor's consent much more extensive. In this article, we review the current thinking and guidelines (which have evolved considerably over the past several decades) regarding these ethical issues using five illustrative case vignettes based on donors personally evaluated by us over the past 35 years. PMID:24849414

  17. Ethical considerations at the end of life in the intensive care unit.

    PubMed

    Gavrin, Jonathan R

    2007-02-01

    Intensive care units (ICUs) confront the healthcare system with end-of-life situations and ethical dilemmas surrounding death. It is necessary for all providers who treat dying patients to have a working knowledge of the philosophical principles that are fundamental to biomedical ethics. Those principles, however, are insufficient for compassionate care. To function well in the intensive care unit, one also must appreciate the behaviors that surround mortality. Human conduct is not predicated solely on rules; complex, unpredictable interactions are the norm. Palliative care, moving forward as a discipline, will become the perfect complement to intensive medical care, rather than being seen as an embodiment of its failures. We need to be as aggressive about respecting patient dignity as we are about using the technology that is central to health care. This article will outline end-of-life ethical principles, explore the sociology that influences human interactions in intensive care units, and show how palliative care should guide behaviors to improve how we deal with death. PMID:17242609

  18. Moral erosion: how can medical professionals safeguard against the slippery slope?

    PubMed

    Liebowitz, Jason

    2011-06-01

    The extensive participation of German physicians in the atrocities of the Holocaust raises many questions concerning the potential for moral erosion in medicine. What circumstances and methods of rationalisation allowed doctors to turn from healers into accomplices of genocide? Are physicians still vulnerable to corruption of their guiding principles and, if so, what can be done to prevent this process from occurring? With these thoughts in mind, the author reflects on his experiences participating in the Fellowships at Auschwitz for the Study of Professional Ethics program and offers a medical student's perspective on the ethical issues encountered in clinical training and the practice of medicine. PMID:21508425

  19. Medical Assisting Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a medical assisting program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the medical assisting field, such as medical law and ethics, typing,…

  20. American Medical Association

    MedlinePLUS

    ... Pediatrics JAMA Psychiatry JAMA Surgery AMA Journal of Ethics AMA Membership Join / Renew Your Membership AMA MVP Program Contact the AMA AMA Affiliates AMA Alliance AMA Foundation AMA Insurance Copyright 1995- American Medical Association All rights reserved. Contact ...

  1. Code of Ethics for the American Association of Physicists in Medicine: report of Task Group 109.

    PubMed

    Serago, Christopher F; Adnani, Nabil; Bank, Morris I; BenComo, Jose A; Duan, Jun; Fairobent, Lynne; Freedman, D Jay; Halvorsen, Per H; Hendee, William R; Herman, Michael G; Morse, Richard K; Mower, Herbert W; Pfeiffer, Douglas E; Root, William J; Sherouse, George W; Vossler, Matthew K; Wallace, Robert E; Walters, Barbara

    2009-01-01

    A comprehensive Code of Ethics for the members of the American Association of Physicists in Medicine (AAPM) is presented as the report of Task Group 109 which consolidates previous AAPM ethics policies into a unified document. The membership of the AAPM is increasingly diverse. Prior existing AAPM ethics polices were applicable specifically to medical physicists, and did not encompass other types of members such as health physicists, regulators, corporate affiliates, physicians, scientists, engineers, those in training, or other health care professionals. Prior AAPM ethics policies did not specifically address research, education, or business ethics. The Ethics Guidelines of this new Code of Ethics have four major sections: professional conduct, research ethics, education ethics, and business ethics. Some elements of each major section may be duplicated in other sections, so that readers interested in a particular aspect of the code do not need to read the entire document for all relevant information. The prior Complaint Procedure has also been incorporated into this Code of Ethics. This Code of Ethics (PP 24-A) replaces the following AAPM policies: Ethical Guidelines for Vacating a Position (PP 4-B); Ethical Guidelines for Reviewing the Work of Another Physicist (PP 5-C); Guidelines for Ethical Practice for Medical Physicists (PP 8-D); and Ethics Complaint Procedure (PP 21-A). The AAPM Board of Directors approved this Code or Ethics on July 31, 2008. PMID:19235389

  2. Principles of automatic processing of speech signals and their application in medical technology and for aids for handicapped.

    PubMed

    Mangold, H

    1988-01-01

    Digital processing of speech signals has made great advances in the last few years. This has brought about many new possibilities for man-machine communication in information technology. Automatic recognition and synthesis of speech signals give chances to communicate in a very direct manner with data processing machines. This gives quite good advances in all areas where communication is often done by vocal commands. Medical technology is one example where people normally use spoken commands to get any action or to produce medical documents by voice input. Another and today still much more important area are aids for handicapped people. There are different tasks which may be done using speech recognizers or synthesizers. For paraplegics it will be important to operate their usual aids through vocal commands. For people with communication defects speech recognizers may be useful for the deaf to aid them in participating in speech communication or for training their speech capabilities. For people with speech defects through e.g. spastic paralysis speech aids may help them to produce an intelligible speech signal from written texts, produced by typing on a keyboard. Blind people may use reading machines with speech output to become relatively independent in text reading and text preparation using typewriters. Speech understanding systems may help to make a direct voice dialogue with medical expert systems. On the other hand, advanced research in hearing psychology and the physiology of speech production may help to develop more advanced automatic speech processing. PMID:2976877

  3. Eer ethics

    SciTech Connect

    Orwant, C.J.

    1994-12-31

    Intelligent agents are personified as epers, electronic personas. Epers can take on various roles as business representatives, financial agents, game players, teachers or civil servants. The ethical deployment of epers requires that they be accountable to their originators, who, in turn, are responsible to the cyberspace communities in which they are involved. Epers must maintain integrity of information, carry out tasks as directed and report accurately on task status. Epers can be custodians of the truth, responsible for certifying that data has not been altered. Public service epers could chair electronic meetings, collect and validate votes on local issues and referee online {open_quotes}flame{close_quotes} wars. Epers` rights include those of privacy, autonomy and anonymity. They could decline to produce information aside from key identifiers and have the right to be protected from arbitrary deletion. Ethical issues include privacy protections, maintenance of appropriate access restrictions, and carrying out business in a secure and trustworthy manner.

  4. Should AAPL enforce its ethics? Challenges and solutions.

    PubMed

    Candilis, Philip J; Dike, Charles C; Meyer, Donald J; Myers, Wade C; Weinstock, Robert

    2014-01-01

    Ethics enforcement in psychiatry occurs at the district branch and American Psychiatric Association (APA) levels under the guidance of American Medical Association (AMA) and APA ethics documents. Subspecialty ethics consequently have no formal role in the enforcement process. This reality challenges practitioners to work according to guidelines that may not be sufficiently relevant and challenges ethics reviewers to apply frameworks not intended for the subspecialties. This article offers the theoretical and practical support to amend APA Procedures to permit formal consideration of subspecialty ethics during ethics complaints and to include forensic practitioners on panels reviewing them. This is the first step toward an integration of two conflicting models of ethics enforcement, regulatory and aspirational, that bring together specialty and subspecialty ethics. PMID:25187285

  5. Biomedical Ethics Policy in Korea: Characteristics and Historical Development

    PubMed Central

    Hahm, Ki-Hyun

    2012-01-01

    Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature. PMID:22661876

  6. Quinacrine sterilization (QS): the ethical issues.

    PubMed

    Bhattacharyya, S

    2003-10-01

    QS has generated debates that are ultimately grounded in various principles, norms, and values. Through a careful analysis of opposing arguments, this paper focuses on two ethical principles claimed by both sides, namely: respect for life and beneficence. Though issues surrounding QS are complex, from the common ground of these two principles, this paper proposes a course of action that addresses many of the concerns from both points of view. PMID:14763181

  7. Ethical Profiling

    Microsoft Academic Search

    Michael Boylan

    2011-01-01

    This essay will argue for ethical procedures governing criminal profiling. A model based upon psychological\\/behavioral data,\\u000a witness data, and forensic profiling data is sketched out. This model fits the legitimate uses of criminal profiling as an\\u000a investigation procedure. Racial profiling as a primary sorting factor does not fit the preferred model and has significant\\u000a downsides and so is rejected as

  8. An overview of the major changes in the 2002 APA Ethics Code.

    PubMed

    Knapp, Samuel; VandeCreek, Leon

    2003-06-01

    This article summarizes the major changes that were made to the 2002 Ethical Principles and Code of Conduct of the American Psychological Association. The 2002 Ethics Code retains the general format of the 1992 Ethics Code and does not radically alter the obligations of psychologists. One goal of the Ethics Committee Task Force was to reduce the potential of the Ethics Code to be used to unnecessarily punish psychologists. In addition, the revised Ethics Code expresses greater sensitivity to the needs of cultural and linguistic minorities and students. Shortcomings of the 2002 Ethics Code are discussed. PMID:16471011

  9. Immortal ethics.

    PubMed

    Harris, John

    2004-06-01

    This article draws on ideas published in my "Intimations of Immortality" essay in Science (Vol. 288, No. 5463, p. 59, April 7, 2000) and my "Intimations of Immortality-The Ethics and Justice of Life Extending Therapies" in editor Michael Freeman's Current Legal Problems (Oxford University Press 2002: 65-97). This article outlines the ethical issues involved in life-extending therapies. The arguments against life extension are examined and found wanting. The consequences of life extension are explored and found challenging but not sufficiently daunting to warrant regulation or control. In short, there is no doubt that immortality would be a mixed blessing, but we should be slow to reject cures for terrible diseases that may be an inextricable part of life-extending procedures even if the price we have to pay for those cures is increasing life expectancy and even creating immortals. Better surely to accompany the scientific race to achieve immortality with commensurate work in ethics and social policy to ensure that we know how to cope with the transition to parallel populations of mortals and immortals as envisaged in mythology. PMID:15247080

  10. [Update of the work of the ethics research in evaluating genetic research and its role as an external ethics committee biobank].

    PubMed

    Alfonso Farnós, Iciar; Hernández Gil, Arantza; Rodríguez Velasco, María

    2013-01-01

    Research on human genome and its applications open great perspectives to improve human beings' health. However, these advances must never endanger the respect of dignity, freedom and rights of the participants in medical research, assuring prohibition of any way of discrimination because of genetic features. The Independent Research Boards (IRB), responsible for safeguarding rights, safety and well-being of the subjects taking part in the biomedical research, assess independently submitted genetic studies, clinical trials whose primary objective is obtaining genetic information and genetic sub-studies of clinical trials with drugs. Biobanks, as safeguarding means to preserve biological samples in suitable quality conditions, must be assigned to two external committees, a scientific one and an ethics one. External ethics committees of biobanks have to make the ethical assessment of the submissions of samples transfers and associated data, in order to carry out research projects. On the other hand, they have to advise biobanks on the compliance of ethical and legal principles, which, in many committees, has turned into the performance of informed consent forms which are in accordance with current laws. PMID:24868962

  11. Public health ethics theory: review and path to convergence.

    PubMed

    Lee, Lisa M

    2012-01-01

    Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the "patient" in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. PMID:22458465

  12. Ethical Dilemmas in Medicine: Who Should Decide?

    ERIC Educational Resources Information Center

    Gorovitz, Samuel

    1978-01-01

    Physicians are in positions to make decisions on which lives depend. The question of who should be making decisions concerning medical research and practice is a moral issue. The problems of medical ethics concern such concepts as autonomy, burden of proof, coercion, informed consent, paternalism, and diminished capacity. (SW)

  13. Ethical challenges in fetal surgery.

    PubMed

    Smajdor, Anna

    2011-02-01

    Fetal surgery has been practised for some decades now. However, it remains a highly complex area, both medically and ethically. This paper shows how the routine use of ultrasound has been a catalyst for fetal surgery, in creating new needs and new incentives for intervention. Some of the needs met by fetal surgery are those of parents and clinicians who experience stress while waiting for the birth of a fetus with known anomalies. The paper suggests that the role of technology and visualisation techniques in creating and meeting such new needs is ethically problematic. It then addresses the idea that fetal surgery should be restricted to interventions that are life-saving for the fetus, arguing that this restriction is unduly paternalistic. Fetal surgery poses challenges for an autonomy-based system of ethics. However, it is risky to circumvent these challenges by restricting the choices open to pregnant women, even when these choices appear excessively altruistic. PMID:21071567

  14. Ethics of fetal tissue transplantation.

    PubMed Central

    Sanders, L M; Giudice, L; Raffin, T A

    1993-01-01

    Now that the Clinton Administration has overturned the ban on federal funding for fetal tissue transplantation, old ethical issues renew their relevance and new ethical issues arise. Is fetal tissue transplantation necessary and beneficial? Are fetal rights violated by the use of fetal tissue in research? Is there a moral danger that the potential of fetal tissue donation will encourage elective abortions? Should pregnant women be allowed to designate specific fetal transplant recipients? What criteria should be used to select fetal tissue transplants? Whose consent should be required for the use of fetal tissue for transplantation? We review the current state of clinical research with fetal tissue transplantation, the legal history of fetal tissue research, the major arguments against the use of fetal tissue for transplantation, and the new postmoratorium ethical dilemmas. We include recommendations for guidelines to govern the medical treatment of fetal tissue in transplantation. Images PMID:8236984

  15. An ethical framework for global psychiatry.

    PubMed

    Katz, Craig L; Lahey, Timothy P; Campbell, Hilary T

    2014-01-01

    Existing literature addresses the ethical considerations of global health work and how medical school curricula can help prepare students for them, but little has been written regarding an ethical approach to global psychiatry. In this paper we summarize prominent ethical issues that arise in global health psychiatry in order to provide a foundation for a framework in global health psychiatry. These issues include obtaining informed consent in the face of language barriers, diagnosing and treating for mental illnesses while navigating communities where such conditions are heavily stigmatized, and justifying the cessation of proving care to current patients for the sake of providing care to new patients abroad. To help prepare psychiatrists and students for work that engages these issues, we propose a multi-step process to assist the practicing global psychiatrist in recognizing ethical dilemmas and evaluating potential courses of action based on their respective ethical merits. PMID:24976554

  16. Ethical management guidelines for the shanghai disease-based biobank network.

    PubMed

    Zhu, Shu; Shen, Mingxian; Qiu, Xiangxing; Gan, Rongxing; Hu, Qingli

    2015-02-01

    The Ethical Management Guidelines for the Shanghai Disease-Based Biobank Network are intended to safeguard the interests of all the participants, to standardize the construction, management, and resource sharing of the Shanghai Disease-based Biobank Network, to promote the development of medical research, and to improve public health and well-being. The guidelines contain seven chapters: General Principles; Informed Consent; Use of Bio-samples from Persons without the Capacity to Consent; Privacy and Confidentiality; Applications of Use of Biological Samples and Data; Intellectual Property and Resource Sharing; and Conflict of Interest. PMID:25686041

  17. Educating about biomedical research ethics.

    PubMed

    Stankovic, Bratislav; Stankovic, Mirjana

    2014-11-01

    This article examines the global and worsening problem of research misconduct as it relates to bio-medico-legal education. While research misconduct has serious legal implications, few adequate legal remedies exist to deal with it. With respect to teaching, research ethics education should be mandatory for biomedical students and physicians. Although teaching alone will not prevent misconduct, it promotes integrity, accountability, and responsibility in research. Policies and law enforcement should send a clear message that researchers should adhere to the highest standards of ethics in research. It is vital that researchers and physicians understand basic aspects of law and the legal system in order to develop understanding of the medico-legal issues not just in the legal context, but with a sound grounding in ethics, social and theoretical contexts so that they can practice good medicine. Routine and holistic research ethics education across the curriculum for medical students and resident physicians, and continuing medical education for practicing doctors, are probably the best ways to accomplish this goal. PMID:24752379

  18. Clinical and research ethics as moral strangers

    Microsoft Academic Search

    Michael H. Kottow

    2009-01-01

    This article takes issue with those who defend a brand of clinical research ethics that tends to substitute the ethics of\\u000a clinical care of patients being recruited as trial subjects. The distinction between therapeutic and non-therapeutic studies\\u000a is being disregarded by arguing that research is concerned with the pursuit of knowledge rather than with the medical benefits\\u000a for patients. Non-competent

  19. Motivations and perceptions of community advisory boards in the ethics of medical research: the case of the Thai-Myanmar border

    PubMed Central

    2014-01-01

    Background Community engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation. Methods In this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region. Results and conclusions Drawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members (and perhaps by community members beyond this) to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. PMID:24533875

  20. Ethics Committee or Community? Examining the identity of Czech Ethics Committees in the period of transition.

    PubMed

    Simek, Jiri; Zamykalova, Lenka; Mesanyova, Marie

    2010-09-01

    Reflecting on a three year long exploratory research of ethics committees in the Czech Republic authors discuss the current role and identity of research ethics committees. The research of Czech ethics committees focused on both self-presentation and self-understanding of ECs members, and how other stakeholders (representatives of the pharmaceutical industry) view them. The exploratory research was based on formal and informal communication with the members of the ethics committees. Members of the research team took part at six regular voluntary meetings of the ethics committees' members, organised by the Forum of Czech Ethics Committees, and at three summer schools of medical ethics. There were realised twenty-five semi-structured interviews as well as six focus group sessions and a participant observation of several regular meetings of three ethics committees. On the grounds of experience from the interviews a simple questionnaire survey was realised among the members of the ethics committees. The ethics committees comprise a community of members working voluntarily, without claims to remuneration or prestige; the unifying goal is protection of subjects of research. The principal working methods are dialogue and agreement. The members of the ethics committees thus, among other things, create an informal community, which can be to a certain extent seen as a Kantian ethical community in a weak sense. The phenomenon of ethics committees can also be described by terms of an epistemic community and a community of practice. These concepts, which are borrowed from other authors and areas, are used as a way how to think of ECs role and identity a bit differently and are meant as a contribution to the current international debate on the topic. PMID:20675735

  1. Ethics, Ricoeur And Philosophy: Ethical Teacher Workshops

    ERIC Educational Resources Information Center

    Scott-Baumann, Alison

    2006-01-01

    This work is about the ethics of education, and about philosophy as a discipline that can help us to help children look at ethics afresh. The study and practice of ethics is about morals and uncertainties and, as such, poses problems for the research community. The philosopher Ricoeur challenges research as only one way to find meaning in the…

  2. Teaching Business Ethics or Teaching Business Ethically?

    ERIC Educational Resources Information Center

    Stablein, Ralph

    2003-01-01

    Notes that one of the most important contexts for ethical decision-making is the nature and operation of "contemporary capitalisms." Suggests that rather than issuing a call for teaching business ethics, the author emphasizes the need for more ethical business teaching. (SG)

  3. Do physicians have an ethical obligation to care for patients with AIDS?

    PubMed Central

    Angoff, N. R.

    1991-01-01

    This paper responds to the question: Do physicians have an ethical obligation to care for patients with acquired immunodeficiency syndrome (AIDS)? First, the social and political milieu in which this question arises is sampled. Here physicians as well as other members of the community are found declaring an unwillingness to be exposed to people with AIDS. Next, laws, regulations, ethical codes and principles, and the history of the practice of medicine are examined, and the literature as it pertains to these areas is reviewed. The obligation to care for patients with AIDS, however, cannot be located in an orientation to morality defined in rules and codes and an appeal to legalistic fairness. By turning to the orientation to morality that emerges naturally from connection and is defined in caring, the physicians' ethical obligation to care for patients with AIDS is found. Through an exploration of the writings of modern medical ethicists, it is clear that the purpose of the practice of medicine is healing, which can only be accomplished in relationship to the patient. It is in relationship to patients that the physician has the opportunity for self-realization. In fact, the physician is physician in relationship to patients and only to the extent that he or she acts virtuously by being morally responsible for and to those patients. Not to do so diminishes the physician's ethical ideal, a vision of the physician as good physician, which has consequences for the physician's capacity to care and for the practice of medicine. PMID:1788990

  4. Ethical issues in HIV/AIDS research, counselling and testing in Nigeria.

    PubMed

    Ajuwon, A J

    2006-12-01

    HIV/AIDS is a major pubic health problem in Nigeria. This paper identifies the ethical issues involved in HIV/AIDS biomedical and behavioural research, counselling and testing in the country. These concerns are discussed in the context of the three universal ethical principles of respect for persons, beneficence, and justice. Written informed consent, which is a component of respect for persons, is a challenge in Nigeria because of skepticism to documentation, sensitivity of sexual practices often explored in behavioural research, and a tradition that discourages patients from questioning medical authority. Although monetary inducement of research participants is ethically acceptable, the high levels of poverty in Nigeria raise concerns that payment of money may unduly induce indigent participants to enroll in research. The disclosure of results in situations when married HIV positive persons insist that their status should not be revealed to their spouse illustrate the dilemma that health workers face in adhering to the ethical norm of keeping confidentiality and the public health obligation of preventing HIV transmission in a third party. Some recommendations are offered to address these concerns. PMID:18050788

  5. [Dignity of the medical toxicologist in the context of medical ethos].

    PubMed

    Brusi?o, Jerzy

    2004-01-01

    On beginning of article two sources of medical ethics: Hippocratic Oath and Good Samaritan (from the parable of Jesus Christ). First, it is paradigm of medicine from antiquity to present times, second this paradigm describes from side of Christian theology and anthropological dates. From point of sight of personalism of traditional source of medical, they make up foundation to appearance of dignity physician of toxicology. Notion of dignity contains many most important guild of physicians in our times, especially physician of toxicology. Principle part of article analyses dignity of physician in worry about life, co-operation with different doctors as well as in context of conscience and in challenges of future. Progress of clinical toxicology has to be connected with moral values and the dignity of medical profession and physician's status. PMID:15521568

  6. The ethics of corporate governance : Crucial distinctions for global comparisons

    Microsoft Academic Search

    G. J. Rossouw

    2009-01-01

    Purpose – The principles, regulations and directives associated with corporate governance constitute a view of the role, responsibilities and obligations of corporations within a given society. Identifying the ethics of a specific corporate governance regime entails making explicit the moral responsibilities and obligations of corporations in society as well as the ethical values associated with these responsibilities and obligations. In

  7. School District Superintendents' Response to Ethical Dilemmas: A Grounded Theory

    ERIC Educational Resources Information Center

    Sprouse, Fay Simpson

    2009-01-01

    Ethical dilemmas, situations involving a conflict between values or principles, often arise when employees of school districts violate laws or professional codes of behavior. Ethical dilemmas also occur when there are inequities in educational programming, resulting in missed opportunities for students. This qualitative study, conducted with the…

  8. Ethical Supervision in Teaching, Research, Practice, and Administration

    Microsoft Academic Search

    Jean Pettifor; Michelle C. E. McCarron; Greg Schoepp; Cannie Stark; Donald Stewart

    2011-01-01

    Supervision is a specialized area of psychological activity that has its own foundation of knowledge, skills, and attitudes, which are enhanced by training. As our discipline develops its standards for competent practice in supervision, there is a need to develop ethical guidelines to assist both supervisors and supervisees in maintaining productive working relationships. Organized around the hierarchy of ethical principles

  9. Operations Research and Ethics: Responsibility, Sharing and Cooperation

    E-print Network

    Gallo, Giorgio

    , are analyzed. Then, two ethical principles, which can help O.R. researchers and practitioners in their activity years. The r^ole of Operations Research in addressing social issues has been advocated among others by Rosenhead [15] [16] and, more recently, by Koch [11]. Schneeweiss [18] analyzes the relations between ethics

  10. An Approach to Ethical Practice in Management and Trainer Training.

    ERIC Educational Resources Information Center

    Johnston, Rita

    1992-01-01

    Concern with ethics has given rise to two educational approaches, one derived from philosophical principles of social ethics, the other based on case studies of practical issues. A combination of these is necessary to ensure situational applicability and to avoid moral relativism and expediency. (SK)

  11. The Jewish patient and terminal dehydration: A hospice ethical dilemma

    Microsoft Academic Search

    Janet Bodell; Marie-Ange Weng

    2000-01-01

    Culturally competent nursing care regarding the ethical dilemma of terminal dehydration (withholding or withdrawing food and fluid) for the Jewish hospice patient involves applying the ethical principles of justice, autonomy, beneficence, and nonmaleficence to nursing interventions by identifying outcomes that focus on the high value Jews place on life; avoiding stereotyping as to what it means to be Jewish; knowledge

  12. The Ethics of Digital Writing Research: A Rhetorical Approach

    ERIC Educational Resources Information Center

    McKee, Heidi; Porter, James E.

    2008-01-01

    The study of writers and writing in digital environments raises distinct and complex ethical issues for researchers. Rhetoric theory and casuistic ethics, working in tandem, provide a theoretical framework for addressing such issues. A casuistic heuristic grounded in rhetorical principles can help digital writing researchers critically…

  13. Workplace Literacy: Ethical Issues through the Lens of Experience

    ERIC Educational Resources Information Center

    Folinsbee, Sue

    2009-01-01

    Even though principles to guide practice are crucial, there are no hard-and-fast rules for resolving ethical issues--dilemmas that are not easily resolvable because they present opposing values and outcomes that may harm to certain groups of people if not properly considered. This article describes a number of ethical dilemmas faced as a workplace…

  14. Distance Supervision in Rehabilitation Counseling: Ethical and Clinical Considerations

    ERIC Educational Resources Information Center

    Lund, Emily M.; Schultz, Jared C.

    2015-01-01

    Background: The use of technology-mediated distance supervision is a rapidly growing area in rehabilitation counseling and other fields. Distance supervision has both tremendous potential and notable challenges to address, including questions of ethics and evidence. Purpose: This article examines both the ethical and nonethical principles that…

  15. Framing ethical acceptability: a problem with nuclear waste in Canada.

    PubMed

    Wilding, Ethan T

    2012-06-01

    Ethical frameworks are often used in professional fields as a means of providing explicit ethical guidance for individuals and institutions when confronted with ethically important decisions. The notion of an ethical framework has received little critical attention, however, and the concept subsequently lends itself easily to misuse and ambiguous application. This is the case with the 'ethical framework' offered by Canada's Nuclear Waste Management Organization (NWMO), the crown-corporation which owns and is responsible for the long-term management of Canada's high-level nuclear fuel waste. It makes a very specific claim, namely that it is managing Canada's long-lived radioactive nuclear fuel waste in an ethically responsible manner. According to this organization, what it means to behave in an ethically responsible manner is to act and develop policy in accordance with its ethical framework. What, then, is its ethical framework, and can it be satisfied? In this paper I will show that the NWMO's ethical and social framework is deeply flawed in two respects: (a) it fails to meet the minimum requirements of a code of ethic or ethical framework by offering only questions, and no principles or rules of conduct; and (b) if posed as principles or rules of conduct, some of its questions are unsatisfiable. In particular, I will show that one of its claims, namely that it seek informed consent from individuals exposed to risk of harm from nuclear waste, cannot be satisfied as formulated. The result is that the NWMO's ethical framework is not, at present, ethically acceptable. PMID:21318321

  16. Ethics in Practice

    ERIC Educational Resources Information Center

    Medlin, E. Lander

    2010-01-01

    Ethics is defined as a set of guidelines and/or rules for the conduct of individual behavior in an organization or civil society. This ethical code of conduct is intended to guide policies, practices, and decision-making for employees on behalf of the organization. This article explores the importance of ethics, the basis for making ethical

  17. Ethical doings in naturecultures

    Microsoft Academic Search

    María Puig de la Bellacasa

    2010-01-01

    What new forms of ethical engagement are emerging in naturecultural worlds? In this paper I explore the example of the practical ethics of the permaculture movement. I put these in dialogue first with new approaches to ethics in biopolitics and naturecultures and second with a reading of feminist care ethics. Across this discussion I focus on the potential of ethos

  18. An Ethics Primer

    NSDL National Science Digital Library

    2008-01-01

    This resource is a PDF that provides engaging, interactive, and classroom-friendly lesson ideas for integrating ethical issues into a science classroom. It also provides a basic background on ethics as a discipline, with straightforward descriptions of major ethical theories. Several decision-making frameworks are included to help students apply reasoned analysis to ethical issues.

  19. Research priorities in medical education in the Eastern Mediterranean Region.

    PubMed

    Amini, M; Kojuri, J; Lotfi, F; Karimian, Z; Abadi, A S H

    2012-07-01

    Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region (EMR). This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research. PMID:22891514

  20. The use of vignettes within a Delphi exercise: a useful approach in empirical ethics?

    Microsoft Academic Search

    Paul Wainwright; Ann Gallagher; Hilary Tompsett; Christine Atkins

    2010-01-01

    There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to

  1. Focus on Ethics and Public Relations Practice in a University Classroom

    ERIC Educational Resources Information Center

    Smudde, Peter M.

    2011-01-01

    Public relations action relies on sound decision making about how to inspire cooperation between an organization and its publics. Such thinking must uphold principles for ethical communication. Effectively combining ethics with public relations practice for students is key. A pedagogical approach to public relations ethics, hinging on selected…

  2. Broadening Student Perspectives on Marketing Research Ethics: Development and Applications of a Teaching Module

    ERIC Educational Resources Information Center

    Handlin, Amy

    2012-01-01

    This paper describes an ethics module developed by the author to engage marketing research students during the fall semester, when they are bombarded by political polls. The module matches ethically questionable polling practices to similarly troubling practices in marketing research. The goals are to show that ethical principles are not topic- or…

  3. A Virtue Ethics Guide to Best Practices for Community-Based Participatory Research

    Microsoft Academic Search

    Marjorie A. Schaffer

    2009-01-01

    Background: Rule ethics, or principled thinking, is important in the analysis of risks and benefits of research and informed consent, but is not completely adequate for guiding ethical responses to communities as research participants and collaborators. Virtue ethics theory can be used to guide actions in relationships, which are foundational to the implementation of community-based participatory research (CBPR). Virtues are

  4. Developing an Ethical Framework in Decision Making of Rural Elementary School Principals in Pennsylvania

    ERIC Educational Resources Information Center

    Hozien, Wafa Ismail

    2012-01-01

    The purpose of this study is to explore and describe individual Pennsylvania rural elementary principals' experiences of ethical decision-making in a complex era. Ethical dilemma, in this case, is the term used to depict an incident which calls for a decision to be made when moral values or ethical principles were in conflict. Also, to learn how…

  5. ETHICS and CSR INSTRUMENTS IN THE FORESTRY SECTOR

    E-print Network

    on ethical principles: · safety and health of workers, consumers, local population · no discrimination and opportunities affect NTFP use and management? ­ Do particular kinds of cases have particular kinds of livelihood

  6. Can ethics survive the onslaught of science?

    PubMed

    Lupton, Michael

    2013-09-01

    The issue on which I will attempt to cast some light is certainly not novel. It has been ongoing for many years but the pace of scientific progress is gathering and the retreat of ethical barriers is relentless. I will illustrate my thesis by using examples of legal decisions from the realm of assisted human procreation and the posthumous conception of children from the sperm of deceased fathers e.g., the cases of Diane Blood, Parpalaix and Nikolas Coltan Evans. I will also highlight the recent case of Ashley X, a nine year old girl whose parents authorised radical medical treatment to arrest her development. I will argue that the law is being driven to roll back the ethical standards derived from our legacy of Natural Law by the imperatives of human rights e.g., the right to found a family, and the quest for patient autonomy. These are both admirable goals but fulfilling these goals comes at a cost to cherished ethical values e.g., that children are conceived by living fathers and that indulging the personal desires of every individual cannot forever be encompassed. As our legislators and courts chip away at our core network of ethical values, are they replacing them with equivalent values or do their decisions amount to a hollowing out of the core ethical values e.g., Thou shalt not kill and that human life is sacrosanct? Yet abortion is legal in many countries as is euthanasia. Paradoxically there is legislative protection for embryos by limiting experimentation on these clusters of cells. How do you construct a rational ethical framework with such blatant legal inconsistencies in the protection of human life? The sanctity of human life constitutes one of the fundamental pillars of ethical values which, in turn, support much more of the structure of ethics. Is a society that permits freezing the development of a nine year old child not a society whose ethics are so compromised that it is doomed to defend an ever diminishing mass of ethical values? Is there a core of ethics which is sacrosanct or is every ethical frontier fair game for invasion? Are the Ethics Committees, which approve and monitor research in the field of bioethics in Universities. Hospitals and laboratories failing in their duty as gatekeepers? They are after all the first line of defence for the survival of crucial ethical values. Can we continue to indulge the whims and needs of every individual under the guise of human rights or patient autonomy? Can a civilised society endure as such with an ever diminishing mass of ethical values? PMID:24340480

  7. Dentistry and ethics by the road less traveled.

    PubMed

    Tiller, Chrissy

    2011-01-01

    In what may be a unique educational career path, this current dental student combined predental course requirements with courses and a master's thesis in applied medical ethics prior to entering dental education. This background has led to leadership opportunities in designing and teaching the ethics program in dental school and in the American Student Dental Association. The view of ethics from the students', rather than the practitioners', perspective is certainly formative to the future of the profession. PMID:22263364

  8. [Influence of the Nuremberg physicians' trials--beginning a new era in the ethical judging of human experiments].

    PubMed

    Kerpel-Fronius, Sándor

    2008-02-01

    This short historical review attempts to shed light on the tortuous road on which society moved toward the general acceptance of the idea of experimenting on human beings. Unfortunately people had to realize that under antihuman or lenient political leadership, some physicians might apply their knowledge against their fellow beings, or might endanger them while pursuing their scientific goals. For this reason, it became necessary to codify the ethical requirements of medical experiments. This was done first by the Prussian government in 1900. The historical significance of the Nuremberg physicians' trials is that, by recognizing the enormous scientific importance of human experiments, they led to the formulation of general ethical principles governing human studies, which became known as the Nuremberg Code. Broad, international regulations were developed as the consequence of the trial. Unfortunately human experiments performed on prison inmates were judged at the trial as ethically acceptable, provided an informed consent was signed. Misusing this possibility many unethical experiments were done primarily in the US after the war. The great indignation due to ethical misconduct in prison trials and the highly unethical Tuskegee experiments performed on black Americans' suffering from syphilis, led much later to the organization of independent ethics committees. Through these committees, society exercises supervision of human trials. However, in case of severely ill patients the physician might be left alone to make a quick, and ethically correct, decision corresponding to the situation. In the final analysis the safety and ethical protection of research subjects remain the joint responsibility of society and of the experimenting physicians. PMID:18218586

  9. October 8, 2013 Applying Ethical Principles to

    E-print Network

    California at San Diego, University of

    Context 4 A.3 The Characteristics of ICTR and Implications for Human Subjects Protection 5 B Relationship for Persons 10 C.1.1 Identification of Stakeholders 10 C.1.2 Informed Consent 11 C.2 Beneficence 12 C.2

  10. Boldt v. Boldt: A pediatric ethics perspective.

    PubMed

    Diekema, Douglas S

    2009-01-01

    On balance, the potential harms and benefits of circumcision in an older child or adolescent are sufficiently closely aligned that parents should be permitted to make decisions about circumcision on behalf of their children. To make a case for prohibition, medical harms would have to be of such likelihood and magnitude that no reasonable potential benefit (social, religious, cultural, or medical) could justify doing it to a child. However, I would suggest that the following additional principles should apply: (1) Informed permission from parents is essential. Only about half of the parents considering neonatal circumcision are given any substantive information about the procedure. That practice is not acceptable for a procedure that is not medically essential and carries some risk of harm. A fully informed consent is essential, and must include a balanced discussion of potential harms and benefits of the procedure to the child. Parents should be given accurate and impartial information and allowed to make an informed decision regarding what is in the best interest of the child. (2) Consent of both parents should be required when the procedure is not medically required. It should not be performed in the face of parental disagreement. (3) Absent a significant medical indication, circumcision should not be performed on older children and adolescents in the face of dissent or less than enthusiastic assent. (4) Circumcision should be performed competently and safely by adequately trained providers.29 This should include infection-control measures, a sterile environment for the procedure, and no mouth-penis contact. (5) Analgesia is safe and effective. Adequate analgesia and post-operative pain control must be provided. In the case of Jimmy Boldt, I would suggest that without some compelling medical reason for performing a circumcision, the procedure should not be performed in the absence of agreement between his parents. The fact that Jimmy's father had sole custody does not eliminate the mother's ethical right and obligation to look after the welfare of her son. While the mother may not have legal decision-making authority, that legal determination does not appear to be related either to a lack of interest in her son's welfare or an inability to carry out that role. Jimmy is her son, and she has an interest in seeing his welfare protected. Whether or not she has legal rights, I would be very reluctant to perform an elective procedure for cultural or religious reasons without the permission of both parents and the unambiguous assent of Jimmy himself. Neither appears to be present in the case as it presented to the courts. PMID:19845198

  11. [Some ethical aspects of donation and transplantation].

    PubMed

    Martínez, K

    2006-01-01

    Ethical and legal consensus in our country bases the practice of donations and transplants on different ethical principles, which are contained in the legislation, closely conforming to the four principles of principialist bioethics: autonomy, beneficence, non-maleficence, and justice. The level of donations achieved in our milieu might, in fact, be related to a strict respect for these principles by the health professionals, as well as to the excellent organisation of the transplant world. Many scientific, technical and ethical challenges have had to be met to reach the present state of the transplant. And there are many current challenges. The article only analyses some of these due to their technical, ethical and social repercussions: organ transplants involving a live donor, the public request for organs, the organ market, the transplant of non-vital organs (basically the face transplant), the use of stem cells and the banks of umbilical cord cells. The aim of the article is to state the ethical problems raised by these new practices, in order to lay the foundations for a moral deliberation that must necessarily involve the whole of society. PMID:17469237

  12. Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore

    PubMed Central

    Humayun, Ayesha; Fatima, Noor; Naqqash, Shahid; Hussain, Salwa; Rasheed, Almas; Imtiaz, Huma; Imam, Sardar Zakariya

    2008-01-01

    Background The principles of informed consent, confidentiality and privacy are often neglected during patient care in developing countries. We assessed the degree to which doctors in Lahore adhere to these principles during outpatient consultations. Material & Method The study was conducted at medical out-patient departments (OPDs) of two tertiary care hospitals (one public and one private hospital) of Lahore, selected using multi-stage sampling. 93 patients were selected from each hospital. Doctors' adherence to the principles of informed consent, privacy and confidentiality was observed through client flow analysis performed by trained personnel. Overall patient perception was also assessed regarding these practices and was compared with the assessment made by our data collectors. Results Some degree of informed consent was obtained from only 9.7% patients in the public hospital and 47.8% in the private hospital. 81.4% of patients in the public hospital and 88.4% in the private hospital were accorded at least some degree of privacy. Complete informational confidentiality was maintained only in 10.8% and 35.5% of cases in public & private hospitals respectively. Informed consent and confidentiality were better practiced in the private compared to the public hospital (two-sample t-test > 2, p value < 0.05). There was marked disparity between the patients' perspective of these ethical practices and the assessment of our trained data collectors. Conclusion Observance of medical ethics is inadequate in hospitals of Lahore. Doctors should be imparted formal training in medical ethics and national legislation on medical ethics is needed. Patients should be made aware of their rights to medical ethics. PMID:18816413

  13. A study in animal ethics in New Brunswick.

    PubMed Central

    Schneider, B J

    2001-01-01

    Society uses animals in ever-increasing numbers and ways, providing ethical challenges. Decisions about animal use are guided by the social consensus ethic towards animals. Because there is no clear social consensus ethic, these decisions are difficult. Society's ethic is changing and a "new ethic" towards animals is emerging. This study addressed the need to better understand society's ethics towards animals. Qualitative research methodology (focus groups) was used to study 7 different animal-interest groups. Qualitative data analysis was computer-aided. The group ethical position towards animals of its own group interest was determined for each group. The animal welfare, companion animal, and veterinary groups took Rollin's Position, a position based on both the Utilitarian and the Rights Principles; the farmer and trapper groups the Utilitarian/Land Ethic position, a dual position based on actions producing the greatest amount of pleasure and the least amount of pain for the greatest number, and preserving the integrity, stability, and beauty of the biotic community; the hunter group the Utilitarian/Judeo-Christian position, a dual position based on actions producing the greatest amount of pleasure and the least amount of pain for the greatest number, and having dominion over animals; and the naturalist group took Rollin's Position/Land Ethic. All these groups perceived medium to extreme ethical responsibility towards animals of their own group's interest that are used by others. The study showed that the predicted "new ethic" towards animals is in New Brunswick society and it is Rollin's Position. PMID:11467182

  14. Virtue vs utility: Alternative foundations for computer ethics

    SciTech Connect

    Artz, J.M. [George Washington Univ., Washington, DC (United States)

    1994-12-31

    Ethical decisions within the field of computers and information systems are made at two levels by two distinctly different groups of people. At the level of general principles, ethical issues are debated by academics and industry representatives in an attempt to decide what is proper behavior on issues such as hacking, privacy, and copying software. At another level, that of particular situations, individuals make ethical decisions regarding what is good and proper for them in their particular situation. They may use the general rules provided by the experts or they may decide that these rules do not apply in their particular situation. Currently, the literature on computer ethics provides some opinions regarding the general rules, and some guidance for developing further general rules. What is missing is guidance for individuals making ethical decisions in particular situations. For the past two hundred years, ethics has been dominated by conduct based ethical theories such as utilitarianism which attempt to describe how people must be behave in order to be moral individuals. Recently, weaknesses in conduct based approaches such as utilitarianism have led moral philosophers to reexamine character based ethical theories such as virtue ethics which dates back to the Greek philosophers Plato and Aristotle. This paper will compare utilitarianism and virtue ethics with respect to the foundations they provide for computer ethics. It will be argued that the very nature of computer ethics and the need to provide guidance to individuals making particular moral decisions points to the ethics of virtue as a superior philosophical foundation for computer ethics. The paper will conclude with the implications of this position for researchers, teachers and writers within the field of computer ethics.

  15. Philosophy and Medical Education.

    ERIC Educational Resources Information Center

    Kopelman, Loretta M.

    1995-01-01

    It is argued that study of philosophy in medical school develops better physicians by teaching salient views of ethical, social, and conceptual problems arising in medical practice. Students learn to examine assumptions, broaden perspectives and gain self-knowledge, develop critical thinking skills, generate tolerance and skepticism about dogma,…

  16. The routinisation of genomics and genetics: implications for ethical practices

    Microsoft Academic Search

    M W Foster; C D M Royal; R R Sharp

    2006-01-01

    Among bioethicists and members of the public, genetics is often regarded as unique in its ethical challenges. As medical researchers and clinicians increasingly combine genetic information with a range of non-genetic information in the study and clinical management of patients with common diseases, the unique ethical challenges attributed to genetics must be re-examined. A process of genetic routinisation that will

  17. Ethical climate in nursing practice: the leader's role.

    PubMed

    Shirey, Maria R

    2005-01-01

    Clarity in an organization's mission, vision, and values is key to effective management in today's complex healthcare work environment. To clearly articulate mission, vision, and values, employees must experience consistency between what is espoused and what is lived. The purpose of this article is to discuss the nurse leader's role in ensuring congruence between caring missions and caring practices. Ethical principles are discussed as the foundation necessary for creating an ethical climate for nursing practice. Components of ethical climate are presented and strategies to create a positive ethical climate for nursing practice are provided. PMID:15937423

  18. Ethical issues in plastic and reconstructive surgery.

    PubMed

    Sterodimas, Aris; Radwanski, Henrique N; Pitanguy, Ivo

    2011-04-01

    Plastic, reconstructive, and cosmetic surgery refers to a variety of operations performed in order to repair or restore body parts to look normal or to enhance a certain structure or anatomy that is already normal. Several ethical considerations such as a patient's right for autonomy, informed consent, beneficence, and nonmalfeasance need to be given careful consideration. The principal objective of the medical profession is to render services to humanity with full respect for human dignity. Plastic surgeons should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion. They require an extensive amount of education and training. The increases in demand for aesthetic plastic surgery and the advocacy of practice in the media have raised concerns about the circumstances under which cosmetic surgery is ethical and permissible. Innovative research, and new technologies derived from such research, almost always raises ethical and policy concerns. Medical ethics regulate what is, and what is not, correct in promoting plastic surgery to the public. It is essential to create an educated and informed public about the ethical issues in the plastic and reconstructive surgery field. Plastic surgeons need to carefully evaluate the degree of deformity, physical and emotional maturity, and desired outcome of patients who request plastic surgery procedures. Science is a powerful force for change in modern society and plastic surgeons have a responsibility to shepherd that change with thoughtful advocacy and careful ethical scrutiny of their own behavior. PMID:21336881

  19. [Codes, guidelines and guidance of ethics of research: the issue of quality].

    PubMed

    Farisco, Michele; Ferrigno, Luigina; Petrini, Carlo; Rosmini, Francesco

    2014-01-01

    After an overview of the evolution of ethics laws for medical activities, we suggest a possible classification of documents regarding the ethical conduct of scientific research with human beings. The authors outline the necessity to define formal criteria for the development and the implementation of ethics standards. PMID:25115481

  20. The ethics of assisted reproduction.

    PubMed

    Chatzinikolaou, Nikolaos

    2010-05-01

    Issues concerning the beginning of life and medical intervention in the onset of human existence are very delicate in their nature; they involve multi-dimensional knowledge, they are difficult to comprehend and sensitive to handle. When pure scientific elements are combined with profound emotions, when the genius of technological discoveries touches upon human dignity and sanctity, when passion for the technological achievement intervenes in basic human rights, then the sense of inadequacy and ignorance becomes intense and critical. Silence seems more sought-after than words, and willingness to learn more prudent than the desire to speak. Fear of the inconceivable consequences and even more so the inability to assess them, experiments with the unknown, the likelihood that basic historical, ethical and social values may change forever, but mainly the replacement of God in His wondrous work of creation--the onset of human life--places the ethics of reproductive technologies on the frontline of contemporary bioethics. This opinion paper does not deal with dangers, insults, fears, threats, "speed limits" or ethical controversies, but rather with the very mystery of life. Although there are no generally accepted replies to the various questions being posed, some thoughts and reservations, which can shed some light upon complicated dilemmas are presented. Firstly, the content of reproductive technologies, the problem of infertility today, the methods of fertility treatment, and of prenatal and pre-implantation testing are described, and then the social impact of IVF, complicated cases, deontological dilemmas and some ethical concerns are discussed. PMID:20412986

  1. Abortion ethics.

    PubMed

    Fromer, M J

    1982-04-01

    Nurses have opinions about abortion, but because they are health professionals and their opinions are sought as such, they are obligated to understand why they hold certain views. Nurses need to be clear about why they believe as they do, and they must arrive at a point of view in a rational and logical manner. To assist nurses in this task, the ethical issues surrounding abortion are enumerated and clarified. To do this, some of the philosophic and historic approaches to abortion and how a position can be logically argued are examined. At the outset some emotion-laden terms are defined. Abortion is defined as the expulsion of a fetus from the uterus before 28 weeks' gestation, the arbitrarily established time of viability. This discussion is concerned only with induced abortion. Since the beginning of recorded history women have chosen to have abortions. Early Jews and Christians forbade abortion on practical and religious grounds. A human life was viewed as valuable, and there was also the practical consideration of the addition of another person to the population, i.e., more brute strength to do the necessary physical work, defend against enemies, and ensure the continuation of the people. These kinds of pragmatic reasons favoring or opposing abortion have little to do with the Western concept of abortion in genaeral and what is going on in the U.S. today in particular. Discussion of the ethics of abortion must rest on 1 or more of several foundations: whether or not the fetus is a human being; the rights of the pregnant woman as opposed to those of the fetus, and circumstances of horror and hardship that might surround a pregnancy. Viability is relative. Because viability is not a specific descriptive entity, value judgments become part of the determination, both of viability and the actions that might be taken based on that determination. The fetus does not become a full human being at viability. That occurs only at conception or birth, depending on one's view of ensoulment. The fetus is owed some moral obligations because of its greatly increased potentiality. After a certain point it deserves legal and moral protection. A woman would have the right to be relieved of carrying the fetus, but she would not have the right to the death of the fetus. A significant moral difference exists in these 2 concepts, and it is this issue that forms the basis of the debate concerning the conflict between maternal and fetal rights. When the rights of the fetus and those of the pregnant woman come into direct conflict the rights of the fetus are always subordinated to those of the women. The 3rd ethical foundation of the abortion debate, that of circumstances of horror and hardship surrounding the pregnancy, is really a combination of the first two. A fetus that is known to suffer from disease or deformity has as many or as few rights vis-a-vis the pregnant woman as does a perfectly healthy fetus. The assignment and hierarchy of fetal rights is not dependent upon the circumstances of conception. The next concern is whether the state can enter the private social spheres to regulate the personal activities of individuals. The Supreme court has never made a statement regarding the moral permissibility of abortion. The Court simply has prevented individual states from interfering with a woman's action based on her personal convictions. This is an important difference, and no step should be taken to abrogate this fundamental civil right. PMID:7041095

  2. 'Iraq Water Treatment Vulnerabilities': a challenge to public health ethics.

    PubMed

    MacQueen, Graeme; Nagy, Thomas; Santa Barbara, Joanna; Raichle, Claudia

    2004-01-01

    A formerly classified US document, 'Iraq Water Treatment Vulnerabilities,' provides evidence that ill health was knowingly induced in the population of Iraq through the ruination of that country's water purification system. We believe that the uncovering of this document should stimulate the public health community to clarify principles of public health ethics and to formulate statements giving voice to these principles. We propose here two statements, one dealing with the broad issue of public health ethics and international relations, and one dealing specifically with public health ethics and water purification. PMID:15260175

  3. Perceptions of ethical problems by forensic psychiatrists.

    PubMed

    Weinstock, R

    1989-01-01

    A survey was undertaken of the opinions of two groups of forensic psychiatrists to determine their views regarding forensic ethical issues. Although AAPL has made significant strides for our profession by adopting ethical guidelines, some important issues have not yet been addressed, as revealed by our survey. Included were items heretofore considered too "controversial" for incorporation into guidelines, as well as items from the APA ethical framework. All APA items were evaluated as addressing ethical problems. The majority of respondents also viewed most of the "controversial" items as confronting relevant ethical problems, thereby suggesting their inclusion, in some form, in the profession's guidelines. They also appeared to favor retention of many traditional medical ethical values when functioning as a forensic psychiatrist. Clear selective discrimination existed among differing death penalty facets. Since AAPL at present does not wish to conduct its own ethics hearings, the AAPL guidelines as well as the items supported in this paper's survey would best be translated into a form consistent with the APA framework. In this way, AAPL's guidelines and also the new suggested items could readily be coordinated within the APA framework and could play a role in the APA local district branch enforcement process. PMID:2758120

  4. An Ethic for Communication in International Development.

    ERIC Educational Resources Information Center

    Swartzendruber, Jan E.

    This paper presents a model of communication's potential role in international development, suggesting that communication specialists use the model to help international development agencies reach their idealized goals. The model proposes that communication specialists follow five ethical principles: concentrate on process rather than program;…

  5. Ethics and Social Responsability in Engineering Courses

    Microsoft Academic Search

    Alessandro LA NEVE

    It is intended to present in this article the experiences and results of the ethics education and social responsability in engineering courses, gotten to the Program of Social Action of Extension in the University Center of the FEI. It has been broken of the principle that the engineer as person has a social paper to play. In such, it is

  6. Induced Abortion: An Ethical Conundrum for Counselors.

    ERIC Educational Resources Information Center

    Millner, Vaughn S.; Hanks, Robert B.

    2002-01-01

    Induced abortion is one of the most controversial moral issues in American culture, but counselor value struggles regarding abortion are seldom addressed in counseling literature. This article considers the conflictual nature of the ethical principles of autonomy, fidelity, justice, beneficence, and nonmaleficence as they can occur within the…

  7. Action Research in Management—Ethical Dilemmas

    Microsoft Academic Search

    Beverly Walker; Tim Haslett

    2002-01-01

    This paper discusses the application of the guiding ethical principles for the conduct of research involving human subjects in an action research project in a membership-based community psychiatric disability organization. Action research is a collaborative process of critical inquiry between the researcher and the people in the situation, in this case the management executive. The relationship between the researcher and

  8. Incorporating patients' spirituality into care using Gadow's ethical framework.

    PubMed

    Pesut, Barbara

    2009-07-01

    Incorporating patients' spiritual beliefs into health care decision making is essential for ethically good care. Gadow's three-level ethical framework of ethical immediacy, ethical universalism, and relational narrative is presented as a tool for enhancing nurses' ability to explore and deepen understandings of patients' spiritual beliefs, given that these and their experiences are often expressed in a language that seems foreign to nurses. The demographic and cultural shifts that lead to the necessity to understand patients who use principles and metaphors that, while commonly understood within their spiritual tradition, may seem incomprehensible to outsiders, are here set in the Canadian context. A case study on palliative sedation is used to illustrate how the ethical framework can help to reveal the spiritual certainties, principles and narratives patients bring to their health care experiences. PMID:19528099

  9. Publication Ethics: A Case Series with Recommendations According to Committee on Publication Ethics (COPE).

    PubMed

    Fazly Bazzaz, Bibi Seddigheh; Sadeghi, Ramin

    2012-09-01

    Ethical misconduct is not a new issue in the history of science and literature. However, ethical misconducts in science have grown considerably in the modern era which is due to emphasis on the scientific proliferation in research institutes and gauging scientists according to their publications. In the current case series, several misconducts occurring over the previous years in Mashhad University of Medical Sciences (Mashhad, Iran) either for Journals or Faculty members were gathered and specific recommendations were provided to avoid similar events in the future. All recommendations are according to Committee on Publication Ethics (COPE). PMID:23493618

  10. Natural law as a unifying ethic.

    PubMed

    Nolan, M T

    1992-01-01

    Natural law asserts that there is an objective moral order that human intelligence can understand and that societies are bound in conscience to follow. In 1772, George Mason appealed to natural law in denouncing a slavery statute in Virginia. This same ethic was called on to convict Nazi war criminals of crimes against humanity in 1948. In the last decade, natural law has enjoyed a resurgence in the medical biomedical ethics literature. It has appeared less frequently in the nursing literature and has been summarily dismissed when it has appeared. Only one nurse ethicist used natural law in discussing ethical issues (organ transplantation). Although further development of this philosophy is required, this ethic shows great promise as a guide to decision making in nursing. PMID:1430657

  11. Ethics and corporate social responsibility – An analysis of the views of Chinese hotel managers

    Microsoft Academic Search

    Gu Huimin; Chris Ryan

    2011-01-01

    Based on a sample of 257 Chinese hotel managers, this paper examines the ethical principles to which these managers adhered. The premise is that any application of the principles of corporate social responsibility (CSR) will be facilitated or inhibited by the degree to which management holds to a strong ethical stance. Developing a questionnaire derived from different sources such as

  12. Ethical currents in a career in science and technology: A case study

    Microsoft Academic Search

    Rodney W. Nichols

    2010-01-01

    Ethical principles are at the heart of the scientific and technological enterprise. That may not always seem to be the case. Doubts become especially emotional when there are deep disagreements as to how much weight should be given to conflicting ethical principles. But in the conduct of their research and in their assessment of applications, scientists and engineers demonstrate a

  13. Ethical and Legal Issues Regarding Selective Abortion of Fetuses with Down Syndrome.

    ERIC Educational Resources Information Center

    Glover, Noreen M.; Glover, Samuel J.

    1996-01-01

    Selective abortion of fetuses with Down syndrome is discussed in terms of abortion perspectives, genetic testing, legislation, and ethical principles. The ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice are offered as guidelines for the examination of legal standards imposed by legislation. (Author/PB)

  14. Ethics in acute care research: a global perspective and research agenda.

    PubMed

    Hirshon, Jon Mark; Hansoti, Bhakti; Hauswald, Mark; Sethuraman, Kinjal; Kerr, Nancy Louise; Scordino, David; Biros, Michelle H

    2013-12-01

    The 2013 Academic Emergency Medicine consensus conference focused on global health and emergency care research. One conference breakout session discussed research ethics and developed a research agenda concerning global acute care research ethics. This article represents the proceedings from that session, particularly focusing on ethical issues related to protecting human subjects while conducting acute care research. Protecting human research subjects from unnecessary risk is an important component of conducting ethical research, regardless of the research site. There are widely accepted ethical principles related to human subjects research; however, the interpretation of these principles requires specific local knowledge and expertise to ensure that research is conducted ethically within the societal and cultural norms. There is an obligation to conduct research ethically while recognizing the roles and responsibilities of all participants. This article discusses the complexities of determining and applying socially and culturally appropriate ethical principles during the conduct of global acute care research. Using case studies, it focuses both on the procedural components of ethical research conducted outside of "Western" culture and on basic ethical principles that are applicable to all human subjects research. This article also proposes specific research topics to stimulate future thought and the study of ethics in these complex circumstances. PMID:24341580

  15. Ethical Relativism and Behavior Therapy.

    ERIC Educational Resources Information Center

    Kitchener, Richard F.

    1980-01-01

    Argues that behavior therapists are really ethical relativists and sometimes ethical skeptics. Ethical naturalism found in operant behavior therapy does entail ethical relativism. Other authors respond to these views. (Author)

  16. Ethical and legal issues in aesthetic surgery.

    PubMed

    Gupta, Suresh

    2012-09-01

    Rapid growth and expansion of plastic surgery in general and aesthetic surgery in particular in the past decade has brought in its wake some confusions particularly raising questions for the surgeons conduct towards his colleagues and the patients in the light of ethical requirements. Some thoughts from eminent thinkers form a backdrop to consideration of theories of medical ethics. In this article raging and continuous debates on these subjects have been avoided to maintain the momentum. Apart from the western thoughts, directions from our old scriptures on ethical conduct have been included to accommodate prevelant Indian practices. The confusion created by specialists advertising their abilities directly to the lay public following removal of ethical bars by the American Courts as also latitudes allowed by the General Medical Council of Great Britain have been discussed. The medical fraternity however has its reservations. Unnecessary skirmishes with the law arose in cosmetic surgery from the freedom exercised by the police to file criminal proceedings against attending doctors in the event of a patient's death with or without any evidence of wrong doing. This has now been curtailed in the judgement of the Supreme Court of India[1] where norms have been laid down for such prosecution. This has helped doctors to function without fear of harassment. An effort has been made to state a simple day-to-day routine for an ethical doctor-patient relationship. PMID:23450235

  17. Live kidney donations and the ethic of care.

    PubMed

    Kane, Francis; Clement, Grace; Kane, Mary

    2008-09-01

    In this paper, we seek to re-conceptualize the ethical framework through which ethicists and medical professionals view the practice of live kidney donations. The ethics of organ donation has been understood primarily within the framework of individual rights and impartiality, but we show that the ethic of care captures the moral situation of live kidney donations in a more coherent and comprehensive way, and offers guidance for practitioners that is more attentive to the actual moral transactions among donors and recipients. A final section offers guidelines for the practice of live kidney transplants that emerge from an ethic of care. PMID:18642067

  18. Common ground: An environmental ethic for Los Alamos National Laboratory

    SciTech Connect

    Menlove, F.L.

    1991-01-01

    Three predominant philosophies have characterized American business ethical thinking over the past several decades. The first phase is the ethics of self-interest'' which argues that maximizing self-interest coincidentally maximizes the common good. The second phase is legality ethics.'' Proponents argue that what is important is knowing the rules and following them scrupulously. The third phase might be called stake-holder ethics.'' A central tenant is that everyone affected by a decision has a moral hold on the decision maker. This paper will discuss one recent initiative of the Los Alamos National Laboratory to move beyond rules and regulations toward an environmental ethic that integrates the values of stakeholder ethics'' into the Laboratory's historical culture and value systems. These Common Ground Principles are described. 11 refs.

  19. Institutional culture and individual behavior: creating an ethical environment.

    PubMed

    Meyers, Christopher

    2004-04-01

    Much of the work in professional ethics sees ethical problems as resulting from ethical ignorance, ethical failure or evil intent. While this approach gets at real and valid concerns, it does not capture the whole story because it does not take into account the underlying professional or institutional culture in which moral decision making is imbedded. My argument in this paper is that this culture plays a powerful and sometimes determinant role in establishing the nature of the ethical debate, i.e., it helps to define what are viable action options, what is the organization's genuine mission, and what behaviors will be rewarded or criticized. Given these conclusions, I also argue that consulting ethicists need more than an understanding of ethics theory, concepts and principles; they also need a sufficiently rich understanding of organizational culture and a willingness and an ability to critique that culture. PMID:15152852

  20. The Noncompliant Patient in Psychiatry: The Case For and Against Covert/Surreptitious Medication

    PubMed Central

    Latha, K. S.

    2010-01-01

    Nonadherence to treatment continues to be one of psychiatry’s greatest challenges. To improve adherence and thus improve the care of patients, clinicians and patients’ family members sometimes resort to hiding medication in food or drink, a practice referred to as covert/ surreptitious medication. The practice of covert drug administration in food and beverages is well known in the treatment of psychiatrically ill world-wide but no prevalence rates exist. Covert medication may seem like a minor matter, but it touches on legal and ethical issues of a patient’s competence, autonomy, and insight. Medicating patients without their knowledge is not justifiable solely as a shortcut for institutions or families wishing to calm a troublesome patient and thus alleviate some of the burdens of care giving. The paramount principle is ensuring the well-being of a patient who lacks the competence to give informed consent. Ethically, covert/surreptitious administration can be seen as a breach of trust by the doctor or by family members who administer the drugs. Covert medication contravenes contemporary ethical practice. Legally, treatment without consent is permissible only where common law or statute provides such authority. The practice of covert administration of medication is not specifically covered in the mental health legislation in developing countries. Many of the current dilemmas in this area have come to public attention because of two important developments in medical ethics and the law - the increasing importance accorded to respect for autonomy and loss of the parens patriae jurisdiction of the courts [parens patriae means ‘parent of the country’; it permitted a court to consent or refuse treatment on behalf of an ‘incapacity’, or alternatively to appoint a guardian with such powers]. PMID:21327173

  1. Ethical issues in the development of new agents.

    PubMed

    Daugherty, C K

    1999-01-01

    In the early drug development process for cancer therapy, several ethical dilemmas result from the use of cancer patients with advanced disease as the subjects of research in clinical trials studying agents of unknown toxicity and/or efficacy. Although several accepted ethical principles guide the behavior of involved physicians and investigators, many of these principles are allowed to be violated in order to achieve the overall goal of clinical research in improving medical care for future patients. Informed consent has been a process viewed by many as a mechanism which protects potentially vulnerable patients from harm in the clinical trial process. However, the ability of the traditionally regulated process of obtaining informed consent for clinical research may be inadequate to ensure appropriate understanding of the purposes and the goals of early clinical trial research by potentially vulnerable advanced cancer patients. This creates further dilemmas with regard to physician-investigator and patient-subject communications. In the setting of phase I trials, where the specific goal of the research is to obtain toxicity information regarding a new potential anticancer agent, many heightened ethical conflicts are present. The fact that patients do not participate in these studies as a result of altruism, and that their main goals of participation are intensely therapeutic, create issues that may be in direct conflict with the research purpose of phase I trials. As well, the presence of therapeutic intentions on the part of involved physician-investigators creates challenging issues when one realizes the very low likelihood of benefit for individual patients participating in these studies. Within the phase II setting, the statistical constraints placed on new drug trials and, again, the low likelihood of benefit for participating-subjects, also creates challenging dilemmas. These statistical requirements may be in direct conflict with involved clinicians' attitudes and beliefs regarding potential efficacy of an agent in this setting. As well, these issues become problematic when thinking about the desired structure and outcome for informed consent in phase II anticancer trials. The ability to conduct clinical research on advanced cancer patients using agents of unknown efficacy and toxicity is a daunting privilege granted to physicians and accompanying institutions. The weight of this privilege should not be underestimated, and involved physician-investigators should be aware of the significant ethical challenges involved in appropriately and successfully conducting this form of research. PMID:10638485

  2. Ethics and Nanotechnology

    NSDL National Science Digital Library

    This page from the Understanding Nano website introduces concepts of nanotechnology-related ethics. In addition to the reading materials, the page provides a list of websites and organizations that focus on ethics and nanotechnology.

  3. Ethical considerations in sex selection.

    PubMed

    Eftekhaari, Tasnim Eghbal; Nejatizadeh, Abdol Azim; Rajaei, Minoo; Soleimanian, Saeede; Fallahi, Soghra; Ghaffarzadegan, Rahman; Mahmoudi, Forough

    2015-01-01

    Advances in modern medicine are resulted from unrestricted and unlimited research disregarding many essentials of a research including ethical issues. Following ethical issues, many of unwanted pregnancies and abortions can be avoided. Several factors such as medical issues including X linked disease, has encouraged couples to select traditional or modern techniques in selecting the gender of their children. Some of these methods are corrected Swim-up method or washing of spermatozoa, Percoll gradient sperm separation method, grass wool column filter method method, albumin separation method, microsort method using FISH (Fluorescence in situ hybridization), free electrophoresis method, Ph adjustment method, pre implantation genetic diagnosis (PGD)/fluorescence in situ hybridization. This technology is confronted with many ethical issues. Ethical considerations PGD in the SEX SELECTION differ in different religions and their perspectives on this issue. In this this review, electronic databases, books and Internet sites were completely searched and full articles including required keywords and techniques were obtained and reviewed. The rites and religions, were different and had legal perspectives and opinions about PGD. In some non-Islamic countries there are strict rules to control the use of technology. Some of these methods are costly and even risky. They also involve ethical issues such as legitimacy of the conceived fetus; recommending final touches in sex selection is still considered a taboo and a big issue in some cultures or mono-sexual families. Islamic views and beliefs are more flexible and the use of these technologies are allowed to preserve the health and lives permit. Islam strongly favors humanity and supports different issues if they are not in conflict with the primary concept of legitimate reproduction and are beneficial to human beings. PMID:26097846

  4. Ethical considerations in sex selection

    PubMed Central

    Eftekhaari, Tasnim Eghbal; Nejatizadeh, Abdol Azim; Rajaei, Minoo; Soleimanian, Saeede; Fallahi, Soghra; Ghaffarzadegan, Rahman; Mahmoudi, Forough

    2015-01-01

    Advances in modern medicine are resulted from unrestricted and unlimited research disregarding many essentials of a research including ethical issues. Following ethical issues, many of unwanted pregnancies and abortions can be avoided. Several factors such as medical issues including X linked disease, has encouraged couples to select traditional or modern techniques in selecting the gender of their children. Some of these methods are corrected Swim-up method or washing of spermatozoa, Percoll gradient sperm separation method, grass wool column filter method method, albumin separation method, microsort method using FISH (Fluorescence in situ hybridization), free electrophoresis method, Ph adjustment method, pre implantation genetic diagnosis (PGD)/fluorescence in situ hybridization. This technology is confronted with many ethical issues. Ethical considerations PGD in the SEX SELECTION differ in different religions and their perspectives on this issue. In this this review, electronic databases, books and Internet sites were completely searched and full articles including required keywords and techniques were obtained and reviewed. The rites and religions, were different and had legal perspectives and opinions about PGD. In some non-Islamic countries there are strict rules to control the use of technology. Some of these methods are costly and even risky. They also involve ethical issues such as legitimacy of the conceived fetus; recommending final touches in sex selection is still considered a taboo and a big issue in some cultures or mono-sexual families. Islamic views and beliefs are more flexible and the use of these technologies are allowed to preserve the health and lives permit. Islam strongly favors humanity and supports different issues if they are not in conflict with the primary concept of legitimate reproduction and are beneficial to human beings. PMID:26097846

  5. [Ethics in aesthetic surgery].

    PubMed

    de Fontaine, S

    2013-09-01

    The use of aesthetic medicine and surgery is increasingly popular, and becomes a true phenomenon of society. Many women and men are asking for such treatments. A large proportion of the population carry the idea that this branch of medicine is a true consumer product. The acts of aesthetic medicine and surgery are not without consequences. They produce important changes in the human body, and carry risks of complications that must be taken into account. The overrated media interest of this subject produce commercial drifts that act against the general health of the patients. The invasive acts of medical aesthetics must be placed in a precise legal and ethical framework to protect the patients. A project of a new Belgian law is on the way, awaiting for publication in "Le Moniteur": this law (proposed by Senator Dominique Tilmans) clarifies the competences required for performing non-surgical aesthetic treatments and specific aesthetic invasive treatments. Other projects of law are being studied, and will concern publicity, information of the public, and rules of private clinics where aesthetic invasive acts are performed. Recent international news have shown, with the PIP breast prosthesis scandal, that surveillance of the medical aesthetic field is mandatory. To provide a better protection of patients, the legislator has decided legislate over the subject. PMID:24195242

  6. Giftedness and Ethics

    ERIC Educational Resources Information Center

    Sternberg, Robert J.

    2012-01-01

    What is, or should be, the role of ethics in giftedness? In this article, I consider why ethical behavior is much harder to come by than one would expect. Ethical behavior requires completion of a series of eight steps to action, the failure of any one of which may result in a person, even one who is ethically well trained, to act in a manner that…

  7. Ethical issues in clinical trials involving nanomedicine

    Microsoft Academic Search

    David B. Resnik; Sally S. Tinkle

    2007-01-01

    Nanomedicine shows tremendous promise for improving medical diagnosis, treatment, and prevention, but it also raises a variety of ethical concerns. Because of the paucity of data on the physicochemical properties of nanoscale materials in biological systems, clinical trials of nanomedicine products present some unique challenges related to risk minimization, management and communication involving human subjects. Although these clinical trials do

  8. Foucault and ethical universality

    Microsoft Academic Search

    Christopher Cordner

    2004-01-01

    Foucault's resistance to a universalist ethics, especially in his later writings, is well-known. Foucault thinks that ethical universalism presupposes a shared human essence, and that this presupposition makes it a straitjacket, an attempt to force people to conform to an externally imposed 'pattern'. Foucault's hostility may be warranted for one - perhaps the usual - conception of ethical universality. But

  9. "Not" Teaching Ethics

    ERIC Educational Resources Information Center

    Wiggins, Alexis

    2011-01-01

    If the goal of teaching ethics is to affect behavior and ultimately produce thoughtful, ethical people, then the best process to do this is by embedding ethical practices in student discussions. One teacher demonstrates how she has done this in her classrooms.

  10. Ethical Child Welfare Practice.

    ERIC Educational Resources Information Center

    Leever, Martin G.; DeCiani, Gina; Mulaney, Ellen; Hasslinger, Heather; Gambrill, Eileen

    Noting that child welfare professionals can improve the quality and integrity of the services they provide if they develop ethical decision making skills, this book provides child welfare administrators and caseworkers with a framework for assessing ethical dilemmas, making sound ethical decisions, and delivering services with integrity to…

  11. Ethics and Privacy.

    ERIC Educational Resources Information Center

    Brewer, Erin; Eastmond, Nick; Geertsen, Reed; Johnson, Doug; Lewandowski, Judith; Yeaman, Andrew R. J.

    2003-01-01

    Contains four articles covering trends and issues on ethics and privacy in instructional technology, including: considerations for assessing ethical issues; what schools must do to develop ethical behaviors in students; a privacy primer for educators; and manufacturing technophopia. Each article contains references. (MES)

  12. Professional Ethics in Education.

    ERIC Educational Resources Information Center

    Rich, John Martin

    Major problems and issues of ethics in elementary, secondary, and higher education are examined. The function and present status of professional ethics are considered, along with specific codes of ethics, including those of the National Education Association, American Association of University Professors, and the American Association of School…

  13. Ethics consultation on demand: concepts, practical experiences and a case study

    PubMed Central

    Reiter-Theil, S.

    2000-01-01

    Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another "committee". One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study. Key Words: Ethics consultation • hospital ethics committee • critical decisions • medical ethics in Germany PMID:10860213

  14. Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams.

    PubMed

    Clark, Phillip G; Cott, Cheryl; Drinka, Theresa J K

    2007-12-01

    Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics. PMID:18038292

  15. Rationing of influenza vaccine during a pandemic: Ethical analyses

    Microsoft Academic Search

    Richard Kent Zimmerman

    2007-01-01

    Rationing of scarce vaccine supplies will likely be required when the next pandemic occurs, raising the questions about how to ration and upon what principles. Because influenza pandemics have differing mortality patterns, such as the 1918 pandemic's “W” shaped curve that effected healthy young adults, the particular pattern should inform rationing. Competing ethical principles for vaccine rationing are utilitarianism and

  16. Ethical Dilemmas in the Treatment of Battered Women in Individual Psychotherapy: Analysis of the Beneficence Versus Autonomy Polemic

    Microsoft Academic Search

    Katie M. Edwards; Jennifer C. Merrill; Angeli D. Desai; John R. McNamara

    2008-01-01

    The purpose of this article is to explore the ethical dilemmas inherent in the treatment of women currently in abusive relationships. Utilizing ethical decision-making models, the conflicting principles of beneficence and autonomy are discussed with regards to whether a therapist should encourage a client to leave an abusive relationship. Given that most ethical decision-making models stress the importance of contextual

  17. Research and Development for a Course in Ethics in Nursing Practice for Community College Associate Degree Nursing Students. Final Report.

    ERIC Educational Resources Information Center

    Roediger, Jeanette

    A project was undertaken to research and acquire the instructional sources needed for a course in ethics for community college associate degree nursing students and to develop such a course. Addressed in the individual units of the course were the following topics: bioethics and ethical decision making, basic ethical concepts and principles,…

  18. The 'Magic Light': A Discussion on Laser Ethics.

    PubMed

    Stylianou, Andreas; Talias, Michael A

    2015-08-01

    Innovations in technology and science form novel fields that, although beneficial, introduce new bio-ethical issues. In their short history, lasers have greatly influenced our everyday lives, especially in medicine. This paper focuses particularly on medical and para-medical laser ethics and their origins, and presents the complex relationships within laser ethics through a three-dimensional matrix model. The term 'laser' and the myth of the 'magic light' can be identified as landmarks for laser related ethical issues. These ethical issues are divided into five major groups: (1) media, marketing, and advertising; (2) economic outcomes; (3) user training; (4) the user-patient/client relationship; and (5) other issues. In addition, issues arising from two of the most common applications of lasers, laser eye surgery and laser tattoo removal, are discussed. The aim of this paper is to demonstrate that the use of medical and para-medical lasers has so greatly influenced our lives that the scientific community must initiate an earnest discussion of medical laser ethics. PMID:25027860

  19. International perspectives on the ethics and regulation of human cell and tissue transplantation.

    PubMed

    Schulz-Baldes, Annette; Biller-Andorno, Nikola; Capron, Alexander Morgan

    2007-12-01

    The transplantation of human cells and tissues has become a global enterprise for both life-saving and life-enhancing purposes. Yet current practices raise numerous ethical and policy issues relating to informed consent for donation, profit-making, and quality and safety in the procurement, processing, distribution, and international circulation of human cells and tissues. This paper reports on recent developments in the international debate surrounding these issues, and in particular on the attention cell and tissue transplantation has received in WHO's ongoing process of updating its 1991 Guiding principles on human organ transplantation. Several of the organizers of an international working group of stakeholders from a wide range of backgrounds that convened in Zurich in July 2006 summarize the areas of normative agreement and disagreement, and identify open questions regarding facts and fundamental concepts of potential normative significance. These issues must be addressed through development of common medical, scientific, legal and ethical requirements for human cell and tissue transplantation on a global basis. While guidance must accommodate the distinct ethical issues raised by activities involving human cells and tissues, consistency with normative frameworks for organ transplantation remains a prime objective. PMID:18278254

  20. Life Science EthicsLife Science Ethics Dr. Kristen Hessler

    E-print Network

    Song, Joe

    · plus · Ethical claims · equals · Ethical conclusion #12;Ethical Argument ­ Example · Human cloning of adults. · Therefore, human cloning is morally wrong. Conclusion Premises #12;Evaluating Ethical Arguments · Human cloning produces exact physical replicas of adults. · It is ethically wrong to produce exact