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Medical ethics: four principles plus attention to scope.

The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work.

Beneficence↗

Ethics committees in state mental hospitals: a national survey.

OBJECTIVE: The goals of the study were to examine the composition, operation, and purpose of ethics committees in state mental hospitals, to determine whether committees were accessible to patients and family members, and to identify frequently addressed ethical issues. METHODS: In June 1992 a 41-item survey questionnaire was mailed to chief executive officers of 204 state-operated general psychiatric inpatient facilities. Survey items asked about the facility's attributes, composition of the ethics committee, how the committee functioned, and the issues it addressed. RESULTS: A total of 145 facilities from 46 states responded to the survey, for a response rate of 71 percent. Nearly half the facilities had ethics committees, most of which were recently established. Physicians accounted for the plurality of committee membership, followed by nurses and administrators. Although several facilities gave patients access to committee meetings, few patients or their family members actually attended these meetings. Issues such as patients' danger to others, resuscitation policies, and scarce resources were frequently addressed by many committees but were never addressed by others. CONCLUSIONS: Although many state mental hospitals have established ethics committees in the past few years, these committees may not meet patients' needs because of inadequate representation by patient advocates and family members. Numerous concerns were heard by committees, but no obvious patterns of pressing issues were revealed.

Bioethical Issues↗

A workshop on medical ethics at the College of Medicine, Lagos University.

As part of an effort to improve the teaching of medical ethics in the College of Medicine, Lagos University two-day workshops were organised. Participants included people from various walks of life, for example politicians, lawyers, doctors, and patients. The workshops were quite successful, and have led to more extensive teaching of medical ethics in the college.

Bioethical Issues↗

The teaching of medical ethics.

Students at Newcastle are exposed to patients during their first week at medical school and attached to a family within the first month. The object is to sensitise them to patients as people rather than vehicles of disease. Medical ethics is introduced as part of the multidisciplinary Human Development, Behaviour and Ageing Course by a lecturer who shows a film which poses an ethical problem. At subsequent tutorials led by the Department of Family and Community Medicine's general practitioner lecturers the subject is discussed as ethical issues arise in the course of their work.

Bioethical Issues↗

Consensus conference on environmental values in radiation protection: a report on building consensus among experts.

During the fall of 2001 (October 22-25), The Norwegian Radiation Protection Authority (NRPA) and the Agricultural University of Norway arranged a consensus conference on the protection of the environment against ionising radiation. The motive for the conference was the need to study the ethical and philosophical basis for protection of nature in its own right. The conference was funded by Nordic Nuclear Safety Research (NKS), in cooperation with the International Union of Radioecology (IUR). The National Committee for Research Ethics in Science and Technology (NENT) was hired as facilitators for the consensus process. This paper will give a brief outline of the aims and method of the conference, distinguishing these from other kinds of consensus conferences. The paper ends with some general reflections on the appropriateness of seeking consensus on ethics-related issues among experts.

Bioethical Issues↗

The process of ethical decision making.

This chapter discusses a framework for and process of ethical decision making in the context of the discipline, theories, and principles of ethics. Daily decision making within the Hospital Ethics Committee is considered and some of the emerging ethical issues in anaesthesia are discussed.

Bioethical Issues↗

The ethics and politics of stem cell research.

INTRODUCTION: Because of the many ocular diseases that may benefit from genetic alteration, ophthalmology will be embroiled in the controversy over the ethics of stem cell research. In preparation for a major academic symposium at the Washington University School of Medicine, the direct and indirect effects of political efforts to determine whether this research should be funded were explored. METHODS: A symposium was held at Washington University School of Medicine sponsored by the Barnes-Jewish Hospital Medical Staff Association to discuss the scientific basis of stem cell research. The forces arrayed on either side of the argument are presented as well as the political context in which they are being played out. RESULTS: Two kinds of effects are expected from this controversy: direct effects on current and proposed research efforts from both within and outside the academic milieu and indirect effects on research funding from state and federal sources influenced by the political process. CONCLUSION: This report serves to document the efforts of one scientific community to deal with a legislative initiative to criminalize stem cell research for both the scientist and the patient. The process and interim conclusions may be instructive for those involved in this endeavor to recognize the dynamics of the interaction between society and science when ethical issues influence how decisions are made.

Bioethical Issues↗