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At least 1,549 records · Page 86Linked to original sources
PubMed1990

Ethics, jurisprudence, and economics in the medical school curriculum.

Medical ethics, medical jurisprudence, and medical economics are recognized as important components of a medical school curriculum. These subjects were introduced through a course given at the University of California, Davis, School of Medicine. Four aspects of the format and content of the course were instrumental to its success. Teaching principles of medical ethics within the context of jurisprudence and economics permitted the students to gain an understanding of the institutions and processes that act as positive and negative constraints on physicians' clinical and professional behavior. The course was offered during the fourth year following required clinical rotations so that all aspects of the course could be based on the clinical experiences of the students. It was presented in a continuing medical education format away from the normal teaching environment of first- and second-year classrooms and third-year clerkships. Finally, the course was designed by a multidisciplinary, multidepartmental planning group that included students.

Bioethical Issues↗
PubMed1990

Enhancing your ethical reasoning.

There is nothing a nurse does more frequently than make decisions, and in intensive care most of these decisions have ethical ramifications. Critical care nurses and other health care professionals must be more effectively prepared to resolve the complex ethical problems that are a natural by-product of health care in the 1990s. Each of us has an obligation as a patient advocate to use a systematic decision-making process, not just an emotive one, when faced with difficult ethical dilemmas. This article presents a decision-making process that is based on the steps of the nursing process, the theories of deontology and utilitarianism, and the strengths in the steps of the valuing process. A difficult case is shared at the end of the article that challenges the reader to examine his or her decision-making capabilities from a systematic and ethical perspective.

Adult↗
PubMed1989

A survey of Army clinicians on hospital ethics committees.

The use of hospital ethics committees (HECs) has increased over the previous 5 to 8 years. A recent survey of physician-administrators in Army Medical Centers and community hospitals revealed that most favored the existence and utilization of these committees within their own hospitals. A follow-up survey was conducted to ascertain the perceptions that clinicians in Army Medical Centers have of these committees and their current or potential utilization in Army hospitals. The results indicate that clinicians as well as physician-administrators in the Army view these committees as beneficial.

Bioethical Issues↗
PubMed1997

The reluctant retained witness: alleged sexual misconduct in the doctor/patient relationship.

Testifying as an expert ethics witness raises a number of important issues. These include: the prospect of generating adverse publicity for oneself and one's institution, avoiding bias, giving testimony that is at odds with testimony given by colleagues, potential conflicts of interest introduced by reimbursement, the need of those who hear the testimony of bioethicists to appreciate the nature of moral expertise, the difficulty of assessing the quality of legal evidence which emerges from adversarial legal proceedings, and the need to consider what weight should be assigned to expert ethics testimony. Along with these issues, what might constitute sexual misconduct is addressed in the essay so that readers can review the decision-making of the author in two cases.

Bioethical Issues↗
PubMed2000

Intention and responsibility in double effect cases.

I argue that the moral distinction in double effect cases rests on a difference not in intention as traditionally stated in the Doctrine of Double Effect (DDE), but in desire. The traditional DDE has difficulty ensuring that an agent intends the bad effect just in those cases where what he does is morally objectionable. I show firstly that the mental state of a rational agent who is certain that a side-effect will occur satisfies Bratman's criteria for intending that effect. I then clarify the nature of the moral distinction in double effect cases and how it can be used to evaluate the moral blameworthiness of agents rather than the moral status of the acts. The agent's blameworthiness is reduced not by his lack of intention but by his desire not to bring about the side-effect, and the 'counterfactual test' can be used to determine whether he desires the effect in acting. In my version, the DDE has its rationale in virtue ethics; it is not liable to abuse as the traditional version is; and it makes more plausible distinctions when applied to standard examples.

Abortion, Therapeutic↗
PubMed1999

Paradigms and personhood: a deepening of the dilemmas in ethics and medical ethics.

There are many calls for a definition of personhood, but also many logical and Wittgensteinian reasons to think fulfilling this is unimportant or impossible. I argue that we can consider many contexts as language-games and consider the person as the key player in each. We can then examine the attributes, presuppositions and implications of personhood in those contexts. I use law and therapeutic psychology as two examples of such contexts or language-games. Each correlates with one of the classic "theories" of ethics-deontology and consequentialism. But each is a large enough cluster to consider them as paradigms in a sense related to Thomas Kuhn's notion in The Structure of Scientific Revolutions. Showing the presuppositions about and "takes" on personhood together with the connections involved in the paradigms deepens the dilemmas we already know to be present.

Bioethical Issues↗
PubMed1991

Consensus of expertise: the role of consensus of experts in formulating public policy and estimating facts.

For years analysts have recognized the error of assuming that experts in medical science are also experts in deciding the clinically correct course for patients. This paper extends the analysis of the use of the consensus of experts to their use in public policy groups such as NIH Consensus Development panels. After arguing that technical experts cannot be expected to be expert on public policy decisions, the author extends the criticism to the use of the consensus of experts in estimating facts to provide a basis for policy decisions. It is argued that to the extent that (a) experts' views regarding a body of facts can be expected to correlate with their values relevant to those facts; and (b) the values of experts differ from the values of lay people, even the estimates of the facts given by the consensus of expert panels can be expected to differ from the estimates lay people would have given had they had the relevant scientific expertise.

Advisory Committees↗