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At least 217 records · Page 12Linked to original sources

Withdrawing and withholding treatment in intensive care. Part 1. Social and ethical dimensions.

Intensive care is an expensive resource. The medical profession has been criticised for applying technology indiscriminately and at vast expense to a relatively small group of patients. The desire of governments to reduce the cost of health care has made rationing of health services a topic of open discussion rather than an implicit activity as it has been in the past. The appropriate response of doctors to these problems is to provide leadership in promoting public awareness and debate of the effects of rationing, and to provide rational allocation of therapy to individual patients. The major issues involving resource allocation in society and to individuals are discussed.

Australia↗

Ethical and cultural dimensions of informed consent. A case study and analysis.

A case of a patient with angina who was considered for coronary bypass surgery illustrates the issue of informed consent. Ethical and legal aspects and the inherent limitations of achieving consent must be considered. Physicians may have personal biases, which may lead to coerced consent, or may overwhelm the patient with information on potential complications of a proposed procedure, which may lead to consent without hope. Patient bias or misinformation may lead to misunderstood consent or, if the patient's judgment is distorted, to crisis consent. The patient's desire to defer the decision to the physician raises the question of whether such requested paternalism violates patient self-determination and invalidates consent or is an exercise of the patient's right to have his physician decide. The case presented exemplifies the patient-physician interaction needed for responsible paternalism.

Aged↗

Medical models and legal categories: an English perspective.

Medical paternalism has been criticised for its denial of patients' rights. Though defended on grounds of patient welfare, it can also be detrimental to that interest. English law has predominantly endorsed medical paternalism, and the criticism of this stance has centered on patients' rights. But within established legal categories there is very little scope for analysis based on the rights of patients, the assertion of which may, in any event, not be conducive to the maximisation of their welfare. This article is primarily concerned with cases arising from the hospital setting, the source of most medical litigation. Its purpose is to argue that an approach grounded in the doctor's responsibility for the patient's welfare, but which affords due respect for patients' rights, accords with legal principle.

Contracts↗

What is a father?

Explore the source record for details and available documents.

Father-Child Relations↗

Futility and the ethics of resuscitation.

Recent recommendations that physicians be allowed to withhold cardiopulmonary resuscitation, without patient consent, from patients for whom it would be futile have drawn objections that such unilateral judgments would undermine respect for patient autonomy. These objections assume that since futility determinations involve value judgments, patient input is always required. However, certain sorts of value judgments must be made unilaterally by physicians as part of reasonable medical practice. Moreover, the mixed messages inherent in requesting patient consent to withhold futile therapy serve to undermine rather than to enhance autonomous choice. Real patient interests can better be saved by a broad public dialogue around judgments of medical reasonableness and medical futility, rather than concern for the form but not the substance of patient autonomy.

Adult↗

Judicial postponement of death recognition: the tragic case of Mary O'Connor.

A recent New York Court of Appeals decision seriously impedes the ability of incompetent patients to control their medical care. In the case of Mary O'Connor, the court virtually eliminated an incompetent's rights to bodily integrity and privacy. The court relied on formalistic evidentiary arguments to vitiate the patient's refusal of death-prolonging treatment. This Case Comment examines both the doctrine and policy underlying the O'Connor decision, suggesting that the court erred in its holding and reasoning. An alternative framework is presented, arguing that courts should honor competently expressed patient decisions concerning medical treatment. New York's highest court, instead, posited an incompetent patient who becomes competent for a moment to render a decision. This legal fiction is nothing more than a thinly masked technique for imposition of the judges' values on the patient. This Case Comment argues that in the absence of clear direction from the patient, family and loved ones generally should make care decisions for the patient.

Aged↗

Ethical considerations in fitness and risk evaluations.

Physicians and other health care workers involved in the delivery of occupational health care can be confronted with difficult questions about fairness, justice and professional ethics. These issues and other ethical considerations are discussed.

Back Injuries↗