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Bioethics.

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Advisory Committees↗

Ethics.

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Bioethical Issues↗

Mode of inquiry.

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Bioethical Issues↗

Teaching medical ethics symposium. A student-led approach to teaching.

It is increasingly agreed that ethics has a place in undergraduate medical education. There is, however, debate about how it should be taught, and by whom. We present our experience of teaching ethics in a general practice module over six years. During this period there has been a shift from a teacher-centred to a student-centred approach in which students choose ethical issues to explore within a framework provided. The issues raised are discussed with examples, and the future directions of our ethics teaching outlined.

Bioethical Issues↗

Cruzan and the constitutionalization of American life.

In America today, public policy governing an increasing number of social issues is made through the judicial enforcement of constitutional rights. Cruzan raised the question whether policy regarding the withdrawal of medical care from incompetent patients is to be handled similarly. This essay argues that privacy-rights doctrine provides a poor basis for constructing public policy in this area. It suggests that the Court has been unable to articulate a convincing basis for privacy rights and that the basis the Court seems to assume poorly fits many circumstances to which it is applied. The essay further contends that the Court has been unable to describe a persuasive method of analyzing the state interests that are at stake in privacy cases and to accommodate those interests in a reasonable way. The essay concludes that these are issues as to which policy is better formed through a political, not judicial, process.

Advance Directives↗

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Adult↗

Mediated realism and the representation of a health care controversy.

Psychologists have recently identified "situated cognition" as an important issue for educators across disciplines. Accordingly, instructional technologists have been working on ways to make classroom materials more true-to-life and affectively engaging. In this article I review a study designed to investigate the ways in which differing realism conditions (delivered through interactive video) influenced users' understanding of the issue of euthanasia and the case of Dax Cowart. Based on the study's findings, I raise the issue of a possible trade-off between traditional values of objectivity and authenticity.

Adolescent↗

Applying Rawls to medical cases: an investigation into the usages of analytical philosophy.

John Rawls's Theory of Justice has been widely and correctly recognized as a tremendous intellectual accomplishment. It has been applauded as a comprehensive and satisfying approach to the problem of defining justice. Health policy analysts and medical ethicists have thus been inspired to apply Rawls's principles to various health care issues. The result has not been greater coherence in approaches to issues of policy and ethics, leading the author to question the validity of Rawls's analytical approach.

Abortion, Legal↗

Ethical decision making by British general practitioners.

General practitioners in England and Wales were sent a questionnaire asking how they would handle the ethical problems posed by six case vignettes and their reasons for their decisions. The ethical problems included: how much information to divulge to patients, how extensively a physician should become involved in the lifestyles of patients and how to deal with a possible family problem. The varying patterns of response to the six cases suggested that ethical issues are resolved in a case-by-case, not a theoretical, basis.

Beneficence↗