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Biomedical subjects

R M Veatch

Publications and source records attributed to R M Veatch.

At least 91 records · Page 5Linked to original sources
PubMed1984

Limits of guardian treatment refusal: a reasonableness standard.

The debate concerning the legal and ethical bases of guardian refusal of medical treatment on behalf of incompetent patients often ignores critical distinctions among types of patients and guardians. For example, patients who have expressed preferences regarding treatment while competent are distinguishable from patients who have always lacked the competency requisite to expressing a treatment preference. "Bonded guardians," whose relationship with the patient preexisted guardianship, should have a different role in the decision-making process than "non-bonded guardians," who were strangers to the patient prior to the guardian-ward relationship. This Article proposes criteria for guardian treatment refusal on behalf of incompetent patients. Under the model for guardian decision making presented here, bonded guardians should be preferred over non-bonded guardians, and bonded guardians should be allowed discretion to make treatment choices, limited only by a standard of reasonableness policed by the courts. The Author presents legal and ethical justifications for the bonded guardian's heightened role. Finally, he considers the proper roles of health professionals, hospital ethics committees, and judges in the decision-making process.

Decision Making↗
PubMed1980

Medical ethics.

Explore the source record for details and available documents.

Abortion, Legal↗
PubMed1980

Voluntary risks to health. The ethical issues.

The discovery that health status is affected by personal life-styles and apparently voluntary health risks poses new problems. It has potential impact on clinical practice, health insurance, and theories of health and disease. Five major problems need attention. First, are these health-risk behaviors really voluntary? Five responses are explored: several other models (the medical, psychological, social structural, and multicausal models) all challenge the assumption of voluntary behavior. Second, are some sufficiently in the public interest that they ought to be subsidized? Third, does justice require that persons bear the costs of truly voluntary health risks? Fourth, what policies should apply to cost-saving, health-risk behavior? Finally, does the voluntary health-risks theme make life too rational and calculating? These issues must be dealt with in future health planning and clinical decision making.

Behavior↗
PubMed1980

Talking about death: patterns of lay and professional change.

For the past thirty years, researchers have surveyed attitudes of providers and patients to the disclosure of the diagnosis and prognosis to the dying cancer patient. Though the lay population has expressed the wish to know over time, a change in provider attitudes is apparent: physicians are now more likely to inform their dying patients of the truth than before. This trend is viewed against a number of precipitating factors: changes in perception of the impact of disclosure and changes in the basic ethical norms related to disclosure with new cohorts of younger physicians reflecting these changes. These correlate with changes in underlying social structure brought about in part by the shift to chronic disease as the paradigm for medical care. With increasingly bureaucratized health care delivery, the physician must collaborate with others who may hold different judgments about what ought to be disclosed. Some nurses not only find it right to disclose, but also in their professional interest. In such settings, honesty may be necessary to avoid conflicting messages to the patient. These shifts may signal underlying shifts in the sick role and in the medical professional role with the patient more active and more knowledgeable in medical decisions and the physician serving as a source of information and counsel.

Attitude of Health Personnel↗