Regulation of psychiatric research: a socioethical analysis.
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Biomedical subjects
Publications and source records attributed to L R Tancredi.
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The paper addresses some of the ethical and legal issues involving the rights of psychiatric patients to refuse treatment. Particular attention is focused on two recently decided cases--Rogers v. Okins, and Rennie v. Klein--that deal with the rights of involuntarily committed patients to refuse psychotropic medications. Both cases approach this issue in different ways, but inevitably point to some very complicated philosophical concepts such as the meaning of self-determination, autonomy and identity of personhood, especially as these concepts are applied to mentally ill patients.
Defensive medicine--the use of diagnostic and end-treatment measures explicitly for the purposes of averting malpractice suits--is frequently cited as one of the least desirable effects of the current rise in medical litigation. Many physicians and policy-makers claim that defensive medicine is responsible not only for the increasing costs of health care but the exposing of patients to significant risks of harm from unnecessary procedures. Very little solid information is available about defensive medicine. The studies that have been conducted have been fraught with statistical difficulties and are by no means definitive. Even more important than the issue of defensive medicine is the more basic problem of our system of compensation for medical injuries.
This paper attempts to determine the extent to which the growing acceptance of deviant behaviors (sexual, sumptuary, and regarding abortion and euthanasia) is related to economic considerations and to draw out some of the attendant implications for health policy in light of notions of social justice. The analysis suggests that economic factors are very influential if not determining variables in this relationship and that they may conflict with "higher-order values" such as human dignity and respect for human life as bases for policy formulation, particularly with respect to the care of the elderly.
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