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Biomedical subjects

H Brody

Publications and source records attributed to H Brody.

At least 37 records · Page 2Linked to original sources
PubMed1998

The internal morality of medicine: explication and application to managed care.

Some ethical issues facing contemporary medicine cannot be fully understood without addressing medicine's internal morality. Medicine as a profession is characterized by certain moral goals and morally acceptable means for achieving those goals. The list of appropriate goals and means allows some medical actions to be classified as clear violations of the internal morality, and others as borderline or controversial cases. Replies are available for common objections, including the superfluity of internal morality for ethical analysis, the argument that internal morality is merely an apology for medicine's traditional power and authority, and the claim that there is no single, "core" internal morality. The value of addressing the internal morality of medicine may be illustrated by a detailed investigation of ethical issues posed by managed care. Managed care poses some fundamental challenges for medicine's internal morality, but also calls for thoughtful reflection and reconsideration of some traditionally held moral views on patient fidelity in particular.

Contracts↗
PubMed1998

A rivalry of foulness: official and unofficial investigations of the London cholera epidemic of 1854.

Contemporaneous with John Snow's famous study of the 1854 London cholera epidemic were 2 other investigations: a local study of the Broad Street outbreak and an investigation of the entire epidemic, undertaken by England's General Board of Health. More than a quarter-century prior to Koch's description of Vibrio comma, a Board of Health investigator saw microscopic "vibriones" in the rice-water stools of cholera patients that, in his later life, he concluded had been cholera bacilli. Although this finding was potential evidence for Snow's view that cholera was due to a contagious and probably live agent transmitted in the water supply, the Board of Health rejected Snow's conclusions. The Board of Health amassed a huge amount of information which it interpreted as supportive of its conclusion that the epidemic was attributable not so much to water as to air. Snow, by contrast, systematically tested his hypothesis that cholera was water-borne by exploring evidence that at first glance ran contrary to his expectations. Snow's success provides support for using a hypothetico-deductive approach in epidemiology, based on tightly focused hypotheses strongly grounded in pathophysiology.

Air Microbiology↗
PubMed1998

The family physician: what sort of person?

BACKGROUND: Character and virtue are as important as knowledge and skills in describing the ideal family physician. Sir Luke Fildes' The Doctor, a widely reproduced painting, provides a visual icon that helps focus attention on important aspects of the character of a "healing sort of person." By stressing rules and principles to the detriment of a good life as a biographical or narrative whole, modern teaching of medical ethics may fail to sufficiently address this aspect of humanism in medicine. Three virtues or character traits that seem necessary for the ideal family physician are humility, compassion, and forgiveness. Such evidence as now exists supports the idea that these physician attributes might be linked to superior health outcomes.

Attitude of Health Personnel↗
PubMed1997

Gag rules and trade secrets in managed care contracts. Ethical and legal concerns.

Gag rules-clauses in managed care contracts that prevent physicians from disclosing information that the plan may find disparaging, but that could relate directly to the patient's health-have recently been the subject of ethical condemnation and legislative prohibition. Another serious problem in managed care contracts, trade secrets, or guidelines and quality assurance mechanisms that are imposed on physicians while their origins are shrouded in proprietary secrecy, have by contrast received little attention. Responses to these ethical challenges to the physician's integrity must involve individual physicians, managed care organizations, professional organizations, and public policymakers.

American Medical Association↗