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Ethical issues in the care of cancer patients.

Nearly all the topics considered by medical ethics generally present themselves to those caring for cancer patients. Although most attention may be given to questions of resource allocation and limiting treatment, other issues are of equal importance. Providing respect and compassion for patients may be even more important. The day-to-day treatment of the patient that recognizes the practical autonomy of the patient and legitimizes the patient's involvement in deciding about his or her own care may do more to preserve the integrity of the patient as a person than anything else that happens to someone who accepts the cancer diagnosis. The physician who can accept the patient's judgment and participation and who can help the patient find positive meaning in what can be a personally and socially devastating disease experience has enacted a highly laudatory ethical standard of patient care.

Beneficence↗

Ethical issues in palliative care: considerations.

Discussions on ethics in palliative care often concentrate on issues like patient autonomy or euthanasia. However, the reality in the developing world begs discussion on an entirely different set of problems altogether. One should have a good death, no doubt, but one should also have an opportunity for a good life. Globalization unfortunately seems to worsen many of the burdens of the developing world, like the negative influence of the mighty pharmaceutical industry. Continuing medical education offered only by the pharmaceutical industry instills bias into the minds of most medical professionals. Prescription practices by many professionals are influenced by the industry; so much so, inexpensive drugs or formulations are abandoned in favor of expensive ones, adding to the burden of a much-suffering individual. Palliative care should have been a major force against such evils, but it seems to get more clinical and institutionalized with time, with the social issues taking a back seat. Unethical research practices and preferential treatment in drug availability are practices that continue to marginalize the less privileged. Adoption of the dominant ideology from the West in the developing world also raises problems like cultural unsuitability. Considering that the bulk of the suffering in the world is in poorer countries, these issues need to be addressed.

Analgesics, Opioid↗

Research into the origins and characteristics of unicorns: mental illness as the unicorn.

Basic research, particularly into the psychological and neurological underpinnings of schizophrenia and other "mental illnesses," is flawed because of its adherence to the ideology that unwanted, hard-to-understand behavior constitutes true medical illness. It is argued here that psychiatric diagnostic terms represent moral judgments rather than medical entities. By reducing experimental subjects to a moral label, and assuming that neurological differences associated with unwanted behavior are brain diseases, researchers fail to take into account the conscious experience, organization of self and self-image, patterns of motivation, history and social contexts of their patients. The failure to consider the psychology of their subjects renders the results of these studies ambiguous and irrelevant for any uses except bolstering the biomedical model of psychiatry.

Behavior Control↗

Categorical diagnosis and a poetics of obligation: an ethical commentary on psychiatric diagnosis and treatment.

Contemporary psychiatric practice reflects the hegemony of the DSM model of human emotional distress. Algorythms are used to decontextualize complaints of distress and classify them into distinct categories of "disorders" based on the presence or absence of specific "symptoms." This is usually followed by the prescription of psychotropic drugs. Such a reductionistic perspective and its mechanical approach to diagnosis and treatment have far reaching epistemological and moral consequences. In this article I address the moral issue from the postmodern ethic articulated by philosopher and theologian John Caputo, which he calls a "poetics of obligation." This position argues for the restoration of respect for the singularity, uniqueness and complexity of each doctor-patient encounter. I further argue for a disempowering of medical model psychiatry and a retrieval of an eclectic holism in psychiatric discourse.

Dehumanization↗

Addressing oppression in psychiatric care: a relational ethics perspective.

In this article we consider oppression in psychiatric care from a relational ethics perspective. We identify the vulnerability of psychiatric patients and the concomitant difficulties that confront medical health practitioners. We suggest that healthcare practitioners can become desensitized to systemic problems in the routine provision of care, that attention to protocols and procedural guidelines is not sufficient to reduce oppression in care, and that the discussion necessary to do so may not be generally supported within clinical environments. We conclude by proposing that the concept of fittingness may allow practitioners to recognize and resolve oppressive aspects of care in a better way and that a culture of questioning needs to be fostered within psychiatry care settings.

Behavior Control↗