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Ethical issues in health care institutions. Lesson 2: Ethical considerations in group decision making and groupthink.

In this second lesson of a five-part WMU/AHRA magazine course on ethics, Dr. Alie tackles an interesting concept--group-think. According to the author, this tendency occurs when cohesive groups lose their ability to critically evaluate alternatives in problem solving. Since groups such as committees or task forces frequently resolve issues and make policy in health care organizations, warning signs of this phenomenon are detailed as well as suggestions to help avoid the problem.

Decision Making, Organizational↗

Ethical issues in health care institutions. Lesson five: Research ethics.

Well-constructed research protocols provide the mechanism to examine new clinical practices and new approaches to the provision of health care services which can be evaluated in a systematic manner. In order to be consistent with the underlying ethical duties of health care providers, the principle of respect for persons requires fully informed consent of those subjects who can act autonomously. If the subjects have diminished autonomy, special precautions must be taken to protect their interests and welfare if they are to take part in research projects which may be of benefit to them. Research, if it is to be consistent with duties of beneficence, must be directed toward the best interests of the subject. Careful attention must be paid to the assessment of potential benefits and risks, so that the balance of benefit to risk is a favorable one. Considerations of fairness prevent us from inequitably distributing the benefits and risks, thus subjecting the most disadvantaged groups in society to further disadvantage. The requirement for prospective review of research protocols by an IRB is important in protecting the rights, health and welfare of people who take part in research.

Ethics, Institutional↗

[Patient care and ethics. VII. Ethics education in the university dental curriculum in the Netherlands].

Dentistry, which has developed independently alongside medicine for more than a hundred years now in the Netherlands, is rooted in a type of natural scientific and technological thinking that gained wide acceptance in the middle of the last century. This type of thinking has had far-reaching consequences for the whole field of medicine, including the independent development of dentistry. The social science side of dental training and the normative aspects of clinical practice have long been seriously neglected as a result of the dominance of the natural sciences. This article surveys development in medicine and dentistry since the middle of the last century. It then examines recent developments in medicine and dentistry and concludes by describing the current status of education in ethics in the dentistry curriculum.

Curriculum↗

[Ethical problems in the clinical evaluation of drugs--role of ethics committees].

The most important item in clinical trials is the informed consent. Information of the patient/subject has to be provided in a clear, for medically not educated people understandable language. Consent has to be given voluntarily and not under duress. The Ethic Committees should--among other things--fulfill the following requirements: Review of the written information sheets, checking of the benefit/risk profile (placebo control group?) and--in the future--perhaps to insist to make the results of the study available to the public.

Austria↗

[Theses on the ethics and legal ethics of abortion].

The author subjects the principal ethical and pragmatic arguments for the moral and legal rejection of abortion to critical scrutiny. He concludes that a prohibition of abortion can be justified neither by considerations of individual and social consequences nor by the standard arguments intended to show that abortion is intrinsically wrong as a form of killing specifically human life.

Abortion, Legal↗

Ethical considerations in the allocation of organs and other scarce medical resources among patients. Council on Ethical and Judicial Affairs, American Medical Association.

Physicians' efforts on behalf of patients often involve the use of resources that, because of naturally limited supply or economic constraints, are not readily available to all who need them. The dilemma in such cases is how physicians may fulfill their ethical duties to "do all that [they] can for the benefit of the individual patient" when the care that they can provide is constrained by the scarcity of needed resources.

American Medical Association↗