It is commonly believed that geriatric medicine generates a distinctive set of ethical problems. Implicated are such issues as resource allocation, competence and consent, advance directives, medical futility and deliberate death. It is also argued that it would be unjust to allow the elderly to compete with younger populations for ...

This paper describes the development of New Zealand policy on posthumous reproduction in assisted human reproduction. It outlines five perspectives: medical, ethical, cultural, psychosocial and legal and shows the multidisciplinary approach taken by the National Ethics Committee. It is argued that each of these perspectives has important contributions to make ...

Suddenly unable to walk, I found resources for facing disability in the works of Aristotle and Nietzsche, even though their respective ethical schemes are incommensurable. Implementing Amélie Rorty's notion of crop rotation, I show how each scheme offers the patient something quite indispensable, having to do with how each has ...

BACKGROUND TO THE STUDY: 1985 witnessed the first transfers of frozen embryos resulting in live births in France. Since this time the number of embryos obtained by in vitro fertilisation (IVF) has increased each year. In 1999 each IVF attempt obtains, on average, 4.5 embryos that can be successfully implanted. ...

For the past decade, there has been a debate raging within the medical, ethical, and legal communities focusing on the issue of medical futility. What has fueled the fires of this multi-faceted debate is the patient rights movement and the perception that the right to self-determination extends not only to ...

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life ...

Encounters between doctors and patients are subtle but complex forms of social interaction. Attempts to regulate aspects of the doctor-patient relationship have a long history. Initially, the production of guidance on principles and conduct was the domain of practitioners. In the 21st century, modern medical ethics still reflects some of ...

The issue of sex selection by using preimplantation genetic diagnosis (PGD) for non-medical reasons has been the subject of heated debate. Although the ethical arguments regarding this subject are complex, we would like to extend and express some views based on practical experience, with a special focus on individual needs ...

In this paper I describe the context and goals of Francisco Vallés In IV librum Meteorologicorum commentaria (1558). Vallés' work stands as a landmark because it interprets a work of Aristotle's natural philosophy specifically for medical doctors and medical theory. Vallés' commentary is representative of new understandings of Galenic-Hippocratic medicine ...

John Peters and his committee had a few basic goals. One was that local, state, and federal governments needed to provide money to construct facilities, support medical research and education, and care for the poor. And they wanted experts to call the shots. Over time, Peters and the committee got ...

Questions surrounding the assessment of medical school applicants' morality are difficult but they are nevertheless important for medical schools to consider. It is probably inappropriate to attempt to assess medical school applicants' ethical knowledge, moral reasoning, or beliefs about ethical issues as these all may be developed during the process ...

What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Three influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal/external account. The first defends an ethic derived from either the ends of medicine or ...

The goals of medical ethics education comprise several dimensions: legal duties to secure informed consent, tell the truth and protect confidentiality; objective competencies that include an understanding of DNR regulations and surrogate decision-making procedures; discursive moral skills such as moral sensitivity, reciprocity and moral development that combine into the capacity ...

There is a consensus among medical geneticists that it is desirable to recontact patients as new information becomes available. Furthermore, some have suggested that there are legal arguments to support an obligation, creating a duty to recontact. Thus far much of the discussion among medical geneticists has focused on the ...

PURPOSE: We propose an ethically justified policy for the number of embryos to transfer in an in vitro fertilization (IVF), by considering fourfactors: medical outcomes, patient's preferences, costs, and market forces of providers. METHODS: We develop an ethical framework that incorporates three ethical principles: beneficence, respect for autonomy, and justice; ...

With the advent of the atomic force microscope (AFM), the study of biological samples has become more realistic because, in most cases, samples are not covered or fixed, which makes it possible to observe them while the cells are alive. This advantage of the AFM allowed the advent of a ...

The unique culture of medical settings impacts the style, pace, and quality of psychological consultation provided in that setting. Matters of life and death and other health emergencies, relationships with the courts, and contact with severely impaired patients are typical events. Medical psychologists (MPs) share many, but not all, of ...

Debates about the moral dilemmas of euthanasia date back to ancient times. Many of the historical arguments used for and against the practice remain valid today. Indeed, any form of discussion on the subject often provokes emotive responses, both from members of the medical profession and the general public. For ...

Rights, autonomy, privacy, and confidentiality are concepts commonly used in discussions concerning genetic information. When these concepts are thought of as denoting absolute norms and values which cannot be overriden by other considerations, conflicts among them naturally occur. In this paper, these and related notions are examined in terms of ...

The use of percutaneous endoscopic gastrostomy for the administration of food and medications in patients with dementia has been on an increase. Many studies have failed to demonstrate the positive outcome expected of this feeding modality for the indications that required tube placement. Hence, the concept of feeding through gastrostomy ...

In this article the fundamentals of a Jewish ethic are set out, through which today's pressing medical ethical questions are then broached. Ethics derive from a basic view of humanity. The Bible teaches that man is created in God's image, and every life is therefore sacrosanct. Second, since life is ...

Critics of the system within which IMEs occur might argue that there is in fact no such entity as a truly impartial evaluation because the practitioner always is aware of the source of payment for the visit and will color opinions in favor of that payor. Nonetheless, the ethical practitioner ...

In this essay, I examine the question of whether it is possible that the encounter with the other could be mediated such that the interval of distance would lose its determining power. I reflect on some instances of extraordinary corporeality, most particularly the phenomenon of conjoined twins, in order to ...

Ethically conducted medical treatment puts the healthcare needs of patients first, ahead of profit, but corporations may pressure GPs to act as their agents instead of the patient's agent. The medical profession requires an industrial code outlining the specific conditions needed to maintain high standards of medical practice. Health professional ...

Today, in developed countries, many HIV-infected people remain in good health thanks to antiviral medication. A growing number of them want to have children. Medical possibilities for preventing contamination of the partners of seropositive men, through assisted reproduction, and of children thanks to antiviral medicines during pregnancy, are summarized. These ...

It is no longer possible or ethically acceptable to deny that rationing occurs in medical practice. We ration already by using "contraindications to treatment". There are no rationing criteria that are universally ethically acceptable. We need ways to establish community preferences if we are to develop responsible methods of rationing ...

Desiderius Erasmus set out his views on medical ethics just over 500 years ago. Applying the characteristic approach of Renaissance Humanism, he drew upon a variety of classical sources to develop his own account of medical obligation. Of particular interest is Erasmus's attention to the patient's duties as well as ...

North American physicians emerge from their medical training with a wide array of professional beliefs and values. Many are thoughtful and introspective. Many are devoted to patients' welfare. Some bring to their work a broad view of social responsibility. Nonetheless, the authors contend that North American medical education favors an ...

The concepts of law and ethics as related to medical practice have always been of paramount importance to the medical profession. This series of three reviews, examines the changes in the law in the last 10 years in relation to ethics and the practice of paediatric anaesthesia. The reviews cover, ...

To examine the ethical issues involved in governmental decisions with potential health risks, we review the history of the decision to raise the interurban speed limit in Israel in light of its impact on road death and injury. In 1993, the Israeli Ministry of Transportation initiated an "experiment" to raise ...

The use of the newly dead to teach procedures is widely practiced in training institutions. This model allows a realistic opportunity both to become more familiar with lifesaving maneuvers before they are actually necessary and to maintain proficiency. Whether to notify the next of kin first has been an issue ...

To incorporate medical ethics into clinical practice, it must first be understood and valued by health care professionals. The recognition of this principle led to an expanding and continuing educational effort by the ethics committee of the Vancouver General Hospital. This paper reviews this venture, including some pitfalls and failures, ...

Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet ...

New insights in medicine and acceptable treatments necessitates an adjustment of the existing definition of clinical or forensic poisoning to: 'An individual's medical or social unacceptable condition as a consequence of being under influence of an exogenous substance in a dose too high for the person concerned'. For medical and ...

The doctor-patient relationship in Korea has been deteriorating, and the numbers of malpractice suits and other medical disputes have been increasing annually for the past decade. Part of the problem may be physicians' lack of ethics education. The author and colleagues surveyed Korean residents from 14 university hospitals and found ...

The modern doctor-patient relationship displays a patient-centred, mutual-participation characteristic rather than the former active-passive or guidance-cooperation models in terms of medical decision making. Respecting the wishes of patients, amounting to more than mere concern for their welfare, has become the feature central to certain modern bioethics theories. A group of ...

In the Western world we have not fully accepted the fact that dying is indeed part of the process of living. Even today in the 21st century, physicians who have historically been taught to diagnose and treat disease with the expectation of cure, still regard death as a failure. We ...

In a recent issue of The Journal of Clinical Ethics, Peter A. Ubel and Ari Silver-Isenstadt reported on patients' willingness to participate in medical education. Their findings and other data they refer to suggest that patients are generally willing to interact with medical students, but that this willingness may vary ...

Medical interviewing is the foundation of medical care and is the clinician's most important activity. A growing body of evidence suggests that clinicians use distinctive, describable behaviors to conduct medical interviews. This article describes four patterns of behavior that we term Habits and reviews the research evidence that links each ...

Despite the profound and pervasive importance of trust in medical settings, there is no commonly shared understanding of what trust means, and little is known about what difference trust actually makes, what factors affect trust, and how trust relates to other similar attitudes and behaviors. To address this gap in ...

This case study examines the matters of competency and informed consent in the case of a patient whose express-but potentially misguided-wishes conflict with medical opinion and the desires of the family. It considers the roles played by emotional, physical and circumstantial factors and attempts to reach a solution which is ...

Medical mistakes is an issue that challenges many healthcare providers and organizations. The challenges are professional, personal, systemswide, financial, and morally compelling; and a fully fitting response may depend on the answer to questions that H. Richard Niebuhr used to divide all ethical considerations: what is going on here; and ...

The Nuremberg Code is a foundational document in the ethics of medical research and human experimentation; the principle its authors espoused in 1946 have provided the framework for modern codes that address the same issues, and have received little challenge and only slight modification in decades since. By analyzing the ...

Ethics, especially medical ethics, is of a great importance in medical informatics field ethical principles have great importance in confidentiality, security, and access to patient records. This is not as simple problem as it looks in the first sight, and--in that context--it is significant that many jurisdictions have drafted laws ...

Recent debates in the ethics of forensic psychiatry have centered on the applicability of traditional medical ethics to forensic practice. Two prominent theories, one taking a principled approach and another taking a narrative approach, have attempted to resolve the tension between medical and legal settings. In this article we contend ...

The ethics of medical management are not always straightforward. There are many contributing factors: the condition treated; its effects on the patient; the required treatment; the effects of that treatment; and a cost/benefit ratio. Treatment of epilepsy with vigabatrin (VGB) exemplifies these problems. VGB has recently been reported to cause ...

BACKGROUND: Formal education in the identification, analysis, and resolution of ethical issues in clinical practice is now an essential component of undergraduate and postgraduate medical education. Physicians educated before the 1980s have had little or no formal education in ethics. This article describes a project for assessing the content and ...

The Nuremberg Code has generally been seen as arising from the Nuremberg Medical Trial. This paper examines developments prior to the Trial, involving the physiologist Andrew Conway Ivy and an inter-Allied Scientific Commission on Medical War Crimes. The paper traces the formulation of the concept of a medical war crime ...

As in any new field, the merger of medicine, e-commerce and the Internet raises many questions pertaining to ethical conduct. Key issues include defining the essence of the patient-provider relationship, establishing guidelines and training for practicing online medicine and therapy, setting standards for ethical online research, determining guidelines for providing ...

Recently, bioethics has become interested in engaging with narrative, but in this engagement, narrative is usually viewed as a mere helpmate to philosophy. In this precis to his book The Fiction of Bioethics, Tod Chambers argues that narrative theory should not be simply a helpful addition to medical ethics but ...