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At least 1,531 records · Page 85Linked to original sources
PubMed1997

The ethics committee of a psychiatric college: its procedures and themes.

OBJECTIVE: Ethics committees (ECs) of medical colleges and other medical associations have become part of their professional experience only in recent years. This is probably attributable to such factors as greater professional accountability and informed consumerism. Relatively little is known about the procedures and agendas of such committees. The aim of the present study was to examine the EC of the Royal Australian and New Zealand College of Psychiatrists, with respect to its practices, in order to learn how a medical college grapples with ethical concerns. METHODS: Two members of the College's EC, including its foundation chairman, assembled relevant documents, and subjected them to detailed scrutiny. Consensus was used, preceded by independent attempts at categorising these issues covering the period from the EC's inception in 1978 to June, 1995. RESULTS: Three hundred and sixty-seven issues were dealt with by the EC over a 17 year period, covering clinical practice, financial aspects, forensic psychiatry, teaching and research, liaison with other organisations and preparation of guidelines and a code of ethics. CONCLUSIONS: An EC can play a vital role in advising its parent body and members in the ethics of day-to-day professional life as well as formulating (and revising) a code of ethics and supplementary ethical guidelines.

Australia↗
PubMed1988

Teaching ethical analysis in occupational therapy.

Ethical decision making is a cognitive skill requiring education in ethical principles and an understanding of specific ethical issues. It is also a psychodynamic process involving personalities, values, opinions, and perceptions. This article proposes the use of case studies and role-playing techniques in teaching ethics in occupational therapy to supplement conventional methods of presenting ethical theories and principles. These two approaches invite students to discuss and analyze crucial issues in occupational therapy from a variety of viewpoints. Methodology of developing case studies and role-playing exercises are discussed. The techniques are evaluated and their application to the teaching of ethics is examined.

Behavior Control↗
PubMed2001

An ethics core curriculum for Australasian medical Schools.

Teaching ethics incorporates teaching of knowledge as well as skills and attitudes. Each of these requires different teaching and assessment methods. A core curriculum of ethics knowledge must address both the foundations of ethics and specific ethical topics. Ethical skills teaching focuses on the development of ethical awareness, moral reasoning, communication and collaborative action skills. Attitudes that are important for medical students to develop include honesty, integrity and trustworthiness, empathy and compassion, respect, and responsibility, as well as critical self-appraisal and commitment to lifelong education.

Australia↗
PubMed1999

Codes of medical ethics and the exportation of less-than-standard care.

Recently a number of AIDS/AZT research studies, carried out by U.S. universities, have come under intense ethical scrutiny. In these studies, control groups of HIV-positive pregnant women were being given a placebo rather than AZT. Such research protocols would be illegal if practiced in the U.S. I examine a number of lamentable ethical lapses in the studies, and conclude that at least some of these ethical problems are traceable to a troubling contradiction between differing international codes of ethics. In a word, some international codes mandate that all research subjects (including control groups) receive the best standard of care available in the country sponsoring the research, while others suggest that providing only a "local" standard of care is ethically appropriate. I argue that these two ethical mandates cannot both be satisfied, and that host country populations will remain subject to exploitation unless this contradiction is resolved.

Codes of Ethics↗
PubMed1998

Ethical practice in managed care: a dose of realism.

This article examines the ethics of medical practice under managed care from a pragmatic perspective that gives physicians more useful guidance than do existing ethical statements. The article begins with a framework for constructing a realistic set of ethical principles, namely, that medical ethics derives from physicians' role as healers; that ethical statements are primarily aspirational, not regulatory; and that preserving patient trust is the primary objective. The following concrete ethical guidelines are presented: Financial incentives should influence physicians to maximize the health of the group of patients under their care; physicians should not enter into incentive arrangements that they are embarrassed to describe accurately to their patients; physicians should treat each patient impartially without regard to source of payment, consistent with the physician's own treatment style; if physicians depart from this ideal, they should inform their patients honestly; and it is desirable, although not mandatory, to differentiate medical treatment recommendations from insurance coverage decisions by clearly assigning authority over these different roles and by physicians advocating for recommended treatment that is not covered.

Disclosure↗
PubMed1989

The importance of being ethical. Essential skills for effective leadership.

The healthcare industry today is in transition from a service industry subject to public regulation to one of self-regulation. The impact of deregulation is severe. Traditional values are being tested; new values are emerging. Can healthcare providers, particularly Catholic providers with their rich history and mission, afford to hang on to traditional values? How do administrators remain competent and compassionate at the same time? Perhaps the time is right to institute corporate ethics to serve as a lifeline for healthcare leaders much in the same way that clinical ethics has served clinicians. The mix of values to which a corporation is committed forms a foundation for practicing corporate ethics. For instance, a corporation can develop means for information gathering and ethical reflection that can shape policy and decisions. Six practical principles for exercising corporate ethics are (1) the chief executive officer is committed to corporate ethics as a management method, (2) the corporation's mission and values are continuously scrutinized to see that they are understood and owned, (3) those responsible for governance and management develop structures and leadership styles consistent with the corporation's value system, (4) the policy-making and decision-making processes include specific ways to ensure that the corporation carefully weighs values as part of business decisions, (5) the corporation evaluates and rewards all employees according to value-driven performance standards, and (6) corporate policy and performance are evaluated annually to determine where the corporation is consistent with its mission and values and where it needs improvement.

Decision Making↗
PubMed2002

Bioethical conflicts between Muslim patients and German physicians and the principles of biomedical ethics.

In the age of globalisation, more and more people who are members of different religions and cultures live in the same society. This situation tends to create many conflicts in different areas of life and not least in the health care system, a fact which raises a number of bioethical issues. The cultural and religious differences between patient and physician can be a cause of bioethical conflicts and therefore represent a challenge for biomedical ethics. The confrontation between Turkish Muslin patients and the German health care system is a convenient example of this situation. The Muslim Turks came to Germany 40 years ago as industrial workers. Their value system had been shaped by traditional and Islamic parameters in Turkey. With this value system, they now found themselves in the German modern health care system. In many fields of modern medicine there are areas of potential conflict of values, where a Muslin patient will argue differently from a secular or Christian person. In an ethical conflict between two individuals who are members of different cultures, it is necessary to make sure that the ethical concept which is to be used for resolving the problem is relevant. In this particular case, both the Islamic legal responses (fatwa) and the classical theories of biomedical ethics are often insufficient. This paper tries to give a brief outline of these bioethical conflicts and discuss these conflicts with regard to the principle of respect for autonomy in the concept of "principilism," as introduced by T.L. Beauchamp and J.F. Childress. The central question is whether this bioethical concept is able to analyse and to help solve the kinds of ethical conflicts which involve transcultural dimensions. This question is discussed with some consideration of the ongoing debate about universalism versus relativism in biomedical ethics.

Communication Barriers↗
PubMedDate not supplied

The ethics of managed care: a dose of realism.

This article examines the ethics of medical practice under managed care from a pragmatic perspective that gives physicians more useful guidance than existing ethical statements. The article begins by stating the authors' starting premises and framework for constructing a realistic set of ethical principles: namely, that bedside rationing in some form is permissible; that medical ethics derive from physicians' role as healers; that actual agreements usually trump hypothetical ones; that ethical statements are primarily aspirational, not regulatory; and that preserving patient trust is the primary objective. The authors then articulate the following concrete ethical guides: financial incentives should influence physicians to maximize the health of the group of patients under their care; physicians should not enter into incentive arrangements that they would be embarrassed to describe accurately to their patients or that are not in common use in the market; physicians should treat each patient impartially, without regard to source of payment, and in a manner consistent with the physician's own treatment style; if physicians depart from this ideal, they must tell their patients honestly; and it is desirable, although not mandatory, to differentiate medical treatment recommendations from insurance coverage decisions by clearly assigning authority over these different roles and by having physicians to advocate for recommended treatment that is not covered.

Conflict of Interest↗
PubMed2005

Current ethical dilemmas in clinical practice in Europe.

The need for clinical ethics support is increasingly recognised by clinicians and health services across Europe, and many countries already have clinical ethics committees. The range of ethical issues for which clinicians may require support is likely to show some similarity across countries, but differences in the frequency and type of ethical issue will also be seen, related to cultural, economic, and systematic differences between countries. In this paper I consider some of the common ethical issues faced by clinicians, drawing on my knowledge and experience of the UK situation, and informed by discussions with other European colleagues. I consider some specific examples to illustrate general issues, and suggest some possible areas of difference that will be important in addressing clinical ethics support in a European wide context.

Bioethical Issues↗
PubMed2006

Methods to identify and address the ethical issues associated with managed care.

There are many benefits of managed care, such as its focus on disease prevention and health promotion, its integration of healthcare services to minimize inefficiencies, and its ability to restrict healthcare costs; however, there are also some ethical concerns that arise from managing care. In the context of managed care, ethics is a method for examining conflicts of values and obligations where there are competing interests, each of which presents a reasonably justified position. The principles of procedural, commutative, and general justice are particularly applicable to the ethical issues associated with managed care. Through a review of relevant literature, this paper will examine different methods and principles of justice to consider in establishing an ethical managed care organization and it will offer some examples of plans that have established policies to meet their ethical goals. By setting common goals, plans and enrollees can minimize ethical conflicts and collaborate to ensure that plans consistently use just procedures to ensure that quality care is available.

Community Participation↗
PubMed1988

Medicine--the art of humaneness: on ethics of traditional Chinese medicine.

This essay discusses the ethics of traditional Chinese medicine. After a brief remark on the history of traditional Chinese medical ethics, the author outlines the Confucian ethics which formed the cultural context in which traditional Chinese medicine was evolving and constituted the core of its ethics. Then he argued that how Chinese physicians applied the principles of Confucian ethics in medicine and prescribed the attitude a physician should take to himself, to patients and to his colleagues. In the last part of the essay he discusses the characteristics of traditional Chinese medical ethics.

Beneficence↗
PubMed1994

The future of healthcare ethics committees.

Ethics committees are fairly common in healthcare institutions in the United States. Comprised of a multidisciplinary membership, including physicians, their functions within institutions are generally threefold: policy recommendation, ethics education and case consultation. The number of such committees will grow as a result of "Patient Rights" standards established by the Joint Commission on Accreditation of Healthcare Organizations (1992 Manual). The author projects and discusses five areas of development and change in the future of healthcare ethics committees. These five areas are: 1) renewed efforts to educate healthcare professionals, 2) cooperation and collaboration among ethics committees, 3) networking with community-based ethics groups, 4) clearer delineation of responsibilities and limitations, and 5) continuous quality improvement. The ability of ethics committees to address successfully these areas of change will determine their future usefulness.

Bioethical Issues↗
PubMedDate not supplied

Bringing the special perspective of the family physician to the teaching of clinical ethics.

BACKGROUND: Medical ethics has traditionally been taught using dramatic, out-of-the-ordinary cases to illustrate principles. Little attention has been focused on the ethical decisions family physicians make routinely in the course of their practice. METHODS: As part of a multidisciplinary course in medical ethics at the University of Washington School of Medicine, one class section was taught by a family physician using cases from her primary care practice. Cases were presented up to the point of decision making. Students were then encouraged to consider what action they would take. Each case was concluded with the family physician sharing the outcome of the case. RESULTS: Five case examples were presented. A comprehensive, context-sensitive approach to patient problems was modeled. Ethical issues explored included financial constraints, resource utilization, substance abuse, truth telling, confidentiality, and patient autonomy. CONCLUSIONS: Case-based teaching by a family physician was very effective at generating interest and enthusiasm among students and in encouraging their own thinking about ethical decisions. Students also valued the exposure to the family physician's style of practice. This teaching method created an excellent opportunity for learning about ethics and primary care that is applicable to many teaching settings.

Adult↗
PubMed1993

Medical ethics--fact or fiction?

In recent times the ethical behaviour of doctors has come under close scrutiny with some unhappy consequences. During the millennia in which medicine has been practised much has been written about ethics and nowadays there is no shortage of codes and declarations and of ethics committees to tell us what to do. These events raise questions about the status of the general principles of ethics and of the significance of particular assertions in that field. There is also the important question of whether or not there has been, or is, any connection at all between utterances about medical ethics and the behaviour of the members of our profession. I believe that the ethical problems confronting doctors are becoming more complex, and give my two rules of thumb for proper behaviour.

Asia↗
PubMed1993

Ethics and the Human Genome Project.

This article provides an overview of ethical issues in genetic testing and screening as they are currently considered in relationship to the Human Genome Project. Previous landmark reports and policy recommendations on genetic testing and screening are briefly described. The goals and research interests of the joint National Institutes of Health/Department of Energy Ethical, Legal, and Social Working Group of the Human Genome Project are outlined. To provide an example of one method by which ethical issues in genetics may be addressed, the ethical framework and practical aspects of a clinical ethics research project at the University of Washington, Seattle, are described. Finally, future directions for the study of ethical and social issues related to genetic testing and screening programs are suggested.

Advisory Committees↗
PubMed1997

[Professional ethics and identity on the background of a changed definition of nursing. Results of a comparative study of physicians and nurses].

There is a greater interest in medical ethical questions as a result of the technical progress in medicine and the greater need for ethical guidance in a pluralistic society. Of course, the ethics of nursing are not excepted from this development either. The necessity of a greater independence of its ethical positions as well as of the idea of the human being is claimed--and even in contrast to medicine. Based on an extensive study the extent and the acceptance of ethical education of the nursing staff-in comparison with medical doctors in contrast is reported. In addition the ethical views of the respective professions regarding the private and the professional area are described.

Ethics, Medical↗
PubMed1994

Clinical ethics as medical hermeneutics.

There are several branches of ethics. Clinical ethics, the one closest to medical decisionmaking, can be seen as a branch of medicine itself. In this view, clinical ethics is a unitary hermeneutics. Its rule is a guideline for unifying other theories of ethics in conjunction with the clinical context. Put another way, clinical ethics interprets the clinical situation in light of a balance of other values that, while guiding the decisionmaking process, also contributes to the very weighting of those values. The case itself originates ideas, not only about which value ought to predominate in its resolution, but also provides the origin of clinical rules that can be used in other cases. These are interpretive rules. Some examples of these rules are presented as well.

Beneficence↗
PubMed1994

Hermeneutical clinical ethics: a commentary.

Essays by Thomasma and ten Have recommend hermeneutical clinical ethics. The use Thomasma makes of hermeneutics is not radical enough because it leaves out basic interpretation of clinical practice and focuses narrowly on ethical principles and rules. Ten Have, while failing to notice that the hyperreality of clinical ethics is a feature of all language, rightly distinguishes four characteristic parameters of a thoroughgoing interpretive clinical ethics: experience, attitudes and emotions, community, and ambiguity. Suggestions are made for implementing hermeneutical ethics in clinical teaching.

Attitude↗