Potential roles of the medical ethicist in the clinical setting.
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Biomedical subjects
Publications and source records attributed to D J Self.
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The model used for teaching ethics at the Ghent Family Medicine Residency at Eastern Virginia Medical School consists of a monthly one-hour noon conference integrating ethical principles and clinical decision making. The underlying objective is to help produce effective physicians by developing their knowledge, skills, and attitudes. The model combines didactic material and clarification of personal values in a case study format. The most important kind of learning to be derived is the self-awareness of one's own value structure and its contribution to the clinical decision-making process. Such a conference will succeed in capturing resident participation in direct proportion to faculty support. Medical ethics teaching in family medicine is appropriate, important, and consistent with the principles of a good family practice residency. An illustration of a typical ethics noon conference on confidentiality is given.
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Improved techniques consisting of glutaraldehyde fixation, Giemsa staining, and colony counter enumeration of foci in viral infectivity assays were compared to microscope scanning and lantern slide projection methods. These techniques broadened the scope of application to potentially hazardous viruses and increased the efficiency of assaying.
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In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way the function as clinical ethicists.
Ethics is an integral part of medical practice and needs explicit attention in family practice residency training programs. One difficulty, however, in developing a medical ethics program in a family practice residency is the lack of information about ethics programs and their strengths and weaknesses. This report provides baseline data on what is being done in 182 family medicine residencies throughout the country. It contains demographic data on locale, size, and age of residency and the perceptions of program directors and chief residents as to the usefulness of such programs, the most frequently discussed issues, the staffing, the amount of curriculum time allocated, and the format employed. Differences of opinion between the two groups are reported.