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PubMed2004

Doctors' duty to disclose error: a deontological or Kantian ethical analysis.

Medical (surgical) error is being talked about more openly and besides being the subject of retrospective reviews, is now the subject of prospective research. Disclosure of error has been a difficult issue because of fear of embarrassment for doctors in the eyes of their peers, and fear of punitive action by patients, consisting of medicolegal action and/or complaints to doctors' governing bodies. This paper examines physicians' and surgeons' duty to disclose error, from an ethical standpoint; specifically by applying the moral philosophical theory espoused by Immanuel Kant (ie. deontology). The purpose of this discourse is to apply moral philosophical analysis to a delicate but important issue which will be a matter all physicians and surgeons will have to confront, probably numerous times, in their professional careers.

Bioethical Issues↗
PubMed2005

Ethical considerations in the application of preconditioning to solid organ transplantation.

The shortage of organs for transplantation has led researchers to look for new techniques to expand the donor pool. Preconditioning strategies have the potential to protect organs from transplant associated injury or may improve the function of substandard organs so that they become suitable for transplantation. Translating this type of technology to the clinical setting raises ethical issues, particularly relating to the deceased donor. It is important that society has the opportunity to discuss the issues raised by implementation of preconditioning strategies before they are implemented rather than as a reaction to them.

Bioethical Issues↗
PubMed2002

Fundamental dilemmas in contemporary psychotherapy: a transtheoretical concept.

The transtheoretical nature of fundamental dilemmas in contemporary psychotherapy is explored. The basic distinction between technical and ethical dilemmas in clinical practice is discussed, as well as the ramifications for the psychotherapist. Clinical dilemmas identified by survey research studies and interviews with master psychotherapists are reviewed. In addition to dilemmas relevant to circumscribed areas of psychotherapy, such as brief therapy, managed mental health care, sexual questions, feminist therapy, dilemmas fundamental to the psychotherapeutic process as a whole are examined. Finally, clinical examples are provided that include such issues as hospitalization of the suicidal patient, dealing with known contraindications, treating the intractable patient, and self-care of the psychotherapist.

Bioethical Issues↗
PubMed1989

Islamic medical ethics in the 20th century.

While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated.

Bioethical Issues↗
PubMed1990

On the dearth of philosophical contributions to medicine.

A recent editorial in this journal calls for more philosophical work in the areas of philosophy of medical science and research methodology. The purpose of the present paper is to bring to light and discuss some obstacles and opportunities for development in these areas. In section I, barriers to increased philosophical work in medicine outside ethics are discussed. In sections II and III, additional areas in medicine ripe for philosphical work are identified and discussed: (a) improving the epistemic fitness of much current clinical reasoning, (b) defining the conditions under which greater epistemic fitness can be achieved, and (c) technology assessment.

Attitude to Health↗
PubMedDate not supplied

The context as a moral rule in medical ethics.

A purely deductive medical ethics cannot properly account for the varieties of circumstances which arise in medical practice. By contrast, a purely inductive medical ethics lacks sufficient guidance from ethical principles. In resolving ethical dilemmas in medicine, most often an appeal is made to middle-level axioms and methodological rules to mediate between theory and practice. I argue that this appeal must be augmented by considerations of context, such considerations, in effect, constituting a moral rule based on the social structure of medical practice. A contextual grid is proposed which assists the process of weighing values in resolving cases.

Bioethical Issues↗
PubMed2002

The professional status of bioethics consultation.

Is bioethics consultation a profession? With few exceptions, the arguments and counterarguments about whether healthcare ethics consultation is a profession have ignored the historical and cultural development of professions in the United States, the ways social changes have altered the work and boundaries of all professions, and the professionalization theories that explain how modern societies institutionalize expertise in professions. This interdisciplinary analysis begins to fill this gap by framing the debate within a larger theoretical context heretofore missing from the bioethics literature. Specifically, the question of whether ethics consultation is a profession is examined from the perspectives of trait theory, Wilensky's five-stage process of professionalization, Abbott's interdependent system of professions, and Haug's deprofessionalization thesis. While healthcare ethics consultation does not meet the criteria to claim professional status, neither could most professions pass these ideal theoretical standards. Instead of a yes or no dichotomous response to the question, it is more helpful to envision a professionalization continuum with sales clerks or carpenters at one end and medicine or law at the other. During the past decade healthcare ethics consultation has been moving along this continuum toward greater professional status.

Bioethical Issues↗
PubMed1985

Are we teaching students that patients don't matter?

Medical students may fear that their training leeches away the caring attitudes which attracted them to medicine. Some research suggests they are right. The medical school has a duty to support and encourage their values, but the reverse may happen. Students are taught about legal consent but not ethical consent. They may see or participate in concealment of medical mistakes and learn to practise deceit. The use of unconscious females for gynaecology teaching may encourage the wrong attitudes to patients. Trainee GPs may learn that the doctors' rights are more important than those of the patient. Measuring patients' views should be included in research protocols.

Bioethical Issues↗
PubMed1989

Advanced medical ethics symposia for fifth-year students.

Case-based, multidisciplinary seminars provided a vehicle for clinicians, philosophers and students to debate current problems in medical ethics in a manner which ensured maximum learning and interest for all participants. Prior training in philosophical medical ethics was an essential prerequisite, giving students the knowledge and skills to take part in the discussions at an appropriate level of sophistication.

Bioethical Issues↗