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Biomedical subjects

D Callahan

Publications and source records attributed to D Callahan.

At least 91 records · Page 5Linked to original sources
PubMed1988

Families as caregivers: the limits of morality.

There is a developing trend to look to families to provide care and support of those in need of rehabilitation. A widespread assumption is that family care is superior care and, with modest degrees of support, families can provide that care. Yet we may question the ethical limits of the obligation of a family or family member to provide care when the demands are severe. Psychologic and moral problems that confront caregivers are examined. In some cases caregivers must sacrifice their present and future welfare. That the moral claim made upon them may seem a justifiable one in many respects does not mean that it will be endurable; that it is endurable does not mean that it is justifiable. The problem is exacerbated by lack of a supportive culture, one that rewards and honors those who take on heroic duties. Caregivers may be socially isolated. If heroic demands are to be made on family members, a richer moral culture is required, not just the provision of improved social services.

Persons with Disabilities↗
PubMed1986

How technology is reframing the abortion debate.

Since the 1973 Supreme Court decision legalizing abortion, medical and scientific developments have focused greater public and professional attention on the status of the fetus. Their cumulative effect may influence legal, social, and moral thought and set the stage for a change in public opinion and a challenge to legalized abortion. There is as yet no inexorable convergence of medical data and legal opinion that would undermine the rational of Roe v. Wade. But the prochoice movement must find room for an open airing of the moral questions if abortion is to remain what it should be--a legally acceptable act.

Aborted Fetus↗
PubMed1986

Abortion: the new debate.

The course of the debate on abortion following the 1973 Supreme Court decision legalizing abortion has been marked by a variety of medical and scientific developments. Many of these new developments have important legal, psychologic, social, moral, and political implications. The cumulative impact of all these developments may pose a significant challenge to the social and legal foundations of Roe v. Wade.

Abortion, Induced↗
PubMed1985

Medicare reform: social and ethical perspectives.

Despite Medicare's success as a social program, its future is in question because of the program's enormous costs. Because the issue of Medicare reform has been forced upon us at this juncture by a crisis of finance rather than by the long-standing inequities in the present system of paying for the health care of the elderly, questions about how best to secure its fiscal integrity have seized the attention of the public. Yet, such questions are hard to contain; they force an examination of broader and more fundamental issues. In this article, we examine the validity of the ultimate moral and social rationales for continuing Medicare in something approximating its present form; the legitimacy of a social entitlement program that is age- rather than means-based; the implications for the future of health care reform if significant changes were to be made in the Medicare program and its underlying rationale; and the possibility that changes in that program may jeopardize the chances for a more rational, just, and systematic approach to the provision of health care to all Americans.

Aged↗
PubMed1985

Hard choices: who lives, how, and who decides? The ethics of making national policy.

Technological advances in medicine and biomedical research have been both exhilarating and depressing. They have heralded prolonged life and with it a moral dilemma regarding the quality of that life. These moral issues are relatively trouble-free on the individual level; however, they become extremely problematic when a policy must be developed which will affect the lives of thousands or millions of people. The persistent problem which is likely to haunt us for decades is the question of allocation of our health care resources--should these health care resources be rationed, and if so, by whom.

Ethics, Medical↗
PubMed1985

Ethics and health care: the next 20 years.

Shifts in moral values in society as they pertain to the future of health care for the next 20 years are discussed. Even though people tend to think that moral dilemmas linger on forever, any number of moral issues that were once hotly debated are now resolved. The trends in health care since World War II--greater access to health care, continual development of new therapies, and elimination of disease and illness--have produced several moral dilemmas. Questions about what society can afford, rationing of health care, and the quality of life now abound; these will directly affect progress in health care in the next 20 years. Expensive technologies that benefit only a few will likely be scrapped in favor of emphasis on low-cost therapies with broader applications. Although complicated, a cost-benefit analysis and exercise should be undertaken to decide whether advances are worth the investments. There have been several shifts in moral values of society that will affect health care over the next couple of decades. Among these are the resurgence of emphasis on the common good (rather than the rights of individuals), movement away from emphasis on rules and principles and toward development of character and virtue, greater sobriety about the negative potential of new technologies, increased group medical practices, and changing ideas about the moral implications of chronic diseases and about the relative roles of the individual and society in improving health.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior↗
PubMed1983

The care of the terminally ill: morality and economics.

Are current expenditures on dying patients disproportionate, unreasonable, or unjust? Although a review of empirical data reveals that care for the terminally ill is very costly, it is not appropriate to conclude that such expenditures represent a morally troubling misallocation of societal resources. Moreover, though efforts to reduce the costs of caring for the dying are not unreasonable, they must be undertaken with great caution. At present, such efforts should concentrate on three basic goals: development of better criteria for admission to intensive- and critical-care units; promotion of patient and family autonomy with regard to decisions to stop or refuse certain kinds of treatment; and promotion of alternative forms of institutional care, such as hospice care. The most difficult moral problems will arise when patients and their physicians seek access to therapies judged only marginally useful. There may be conflict between administrators with broad institutional responsibilities and clinicians committed to particular patients.

Cost-Benefit Analysis↗
PubMed1983

Endometriosis of the ureter can present as renal failure: a case report and review of endometriosis affecting the ureters.

Of the female subjects with pelvic endometriosis 1.2 per cent are found to have involvement of the genitourinary tract. Ureteral obstruction secondary to endometriosis is uncommon and usually is unilateral. We report a case of renal failure with hypertension due to bilateral ureteral obstruction from pelvic endometriosis. Ureteral endometriosis and its treatment are discussed. In premenopausal women presenting with bilateral obstruction of the distal ureters endometriosis should be part of the differential diagnosis.

Acute Kidney Injury↗