Classical medicine operates in a climate of rational discourse, scientific knowledge accretion and the acceptance of ethical standards that regulate its activities. Criticism has centred on the excessive technological emphasis of modern medicine and on its social strategy aimed at defending exclusiveness and the privileges of professional status. Alternative therapeutic ...

Present-day case managers find themselves facing a broad range of ethical issues and value conflicts. For managers of the frail older person, these issues may relate to (a) the client, (b) the client's family, (c) the manager's agency, (d) interdisciplinary interactions, (e) interagency dynamics, and (f) the entire service system. ...

The attention given to the spiritual dimension in the "helping professions" practice represents a major step for a coherent approach toward the ethical aspects in the resolving individual and familial conflicts; furthermore they can be used as a key in understanding dysfunctional relationship. Psychiatry interest for religion and mysticism must ...

Dietitians face both a responsibility and an opportunity to address the ethical issues of obesity treatment and to promote weight management strategies that are beneficial and effective. The Code of Ethics for the Profession of Dietetics, which was adopted in 1989 to provide guidance to dietetics practitioners in their professional ...

Pain management, a primary focus of the oncology nurse, is undergoing a technologic boom. Assessment of high-tech treatments in medicine is an underdeveloped and controversial area. This paper is intended to promote critical thinking about methods of high-tech pain relief such as subcutaneous, IV, and intraspinal analgesia and anesthesia delivered ...

Considerable debate has occurred about the proper role of philosophers when offering ethics consultations. Some argue that only physicians or clinical experienced personnel should offer ethics consultations in the clinical setting. Others argue still further that philosophers are ill-equipped to offer such advice, since to do so rests on no ...

Trust and respect between physician and chaplain is built over a period of time, through deliberate effort. It is something that may be present from the start, but will be tested in conflict. On the physician's side a respect for religion in medicine must be developed. On the chaplain's side ...

The ability to recognize and respond to the ethical dimension of medicine is integral to providing health care that is comprehensive and humane. However, this aspect of medical practice is underemphasized in clinical and academic medicine, despite attempts to devise curricula in this field. This paper examines the origins and ...

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. ...

Medico-philosophical reflections were developed in the 19th and the 20th centuries by three consecutive generations of Polish physicians, active in what was later named the Polish School of Philosophy of Medicine. The second generation of this school published its own journal, Medical Critique [Krytika Lekarska], from 1897 to 1907. Medical ...

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics ...

Edmund D. Pellegrino's philosophy of medicine is explored in categories such as the motivation in constructing a philosophy of medicine, the method, the starting point of the doctor-patient relationship, negotiation about values in this relationship, the goal of the relationship, the moral basis of medicine, and additional concerns in the ...

Physicians have for some time been questioning the prevailing view of medicine as applied biology. It is urged that medicine needs to be reconceived so as to provide appropriate emphasis on the patient's experience and understanding of illness. After reviewing these arguments and the scientific paradigm underlying the received view ...

Managing suicidal behavior of individuals with borderline personality disorder presents both therapeutic and ethical/legal dilemmas. It is argued in this paper that clinicians treating borderline individuals need to carefully discriminate "acute" from "chronic" suicidal states. For "acute" suicidal situations, traditional management approaches are appropriate. However, for "chronic" situations, common among ...

We present an ethically justified, clinically comprehensive management strategy for third-trimester pregnancies complicated by fetal anomalies, based on 72 cases diagnosed at a gestational age of more than 24 weeks. These cases are organized into three categories: A) nonaggressive management and termination of pregnancy offered, three of 72 (4%); B) ...

Instruction in medical ethics has become standard in undergraduate medical education within the past decade; more recently, several specialty boards have formally endorsed ethics teaching and evaluation for residents as well. However, the current emergency medicine Core Content, representing emergency medicine's central body of knowledge, makes no specific mention of ...

A brief summary is given of the factors which make knowledge of and sensitivity for medical ethics necessary for all health professionals today. It is then noted that most activities in this field are centered around diagnostic and therapeutic medicine, the one-to-one, doctor-to-patient relationship. Reasons are then given why ethical ...

Present 'techno-medicine' has brought about clinical results that were simply unthinkable only a few years ago. Just how positive these results really are is beginning to emerge today with growing clarity. Yet, typical of techno-medicine is the way it solves certain problems whilst at the same time creating others. Organ ...

In discussing such issues as euthanasia and eugenics there has been no lack of oblique references to Nazi medicine and the Nuremberg Trials. It is as if the impact of Nazi medicine on medical ethics has been most pronounced in its rhetoric, and regrettably also in inapt comparisons Is it ...

Rapid strides have been made in the management of infertility with newer and advanced techniques. The acceptability of the procedure, the immediate and remote outcome are linked with different aspects in different countries and nations. The new discipline of bio-ethics deals with the ethical implications of biological phenomenon as manipulated ...

This paper reviews the problems and prospects involved in providing computer-aided decision support in clinical medicine. First, the evaluation of medical innovation is discussed. It is suggested that there are three criteria by which an innovation may be judged, namely (1) a need for the innovation, (2) the ability of ...

The practice of occupational medicine has been portrayed as being fraught with ethical conflict and yet this problem has received little systematic study. A question and case study survey of a randomly selected cohort of members of the American Occupational Medical Association has been performed to examine the extent and ...

Modern developments in science, technology and medicine have resulted in an unprecedented interest in ethical and moral issues in the practice of medicine. Changes threaten to erode the traditional ethos of practice and to transform medicine into a marketable commodity. The challenge of a new medical ethic and suggestions for ...

Robert Veatch has claimed that virtue theory is not only irrelevant but potentially dangerous in medical ethics. I argue that virtue is a far more prominent factor in contemporary medical practice than Veatch admits. Even if 'stranger medicine' is taken as the norm, proper conduct on the part of physicians ...

The burglar's request, "your money or your life," follows our rescue imperative made possible with technological advances in medicine. We can now keep extremely sick and dying patients alive at great cost. Often, we spend large amounts of money on extraordinary treatment and the patient still dies. The Rev. Meyer ...

The medical profession has lost much of its power to control the production of knowledge, practice, and organization of medicine, but it was never the dominant force in shaping medicine. Instead, medicine has evolved in response to many different, and often conflicting, social, political, and economic forces, including professional forces. ...

A unique relationship exists between physicians and philosophers -- one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. ...

Trial of labor is a safe and effective management alternative but remains underused in current clinical practice. To explore whether this underuse is justified, decision analysis is developed to compare a trial of labor with elective repeat cesarean section. With the use of available probability estimates and outcome scoring based ...

Despite the dramatic increase over recent years in the research and teaching of medical ethics, there exists no theoretical framework within which to conceptualize ethical problems in medicine, to say nothing of solutions to these problems. The model proposed here attempts to fill this void by developing a conceptual understanding ...

The ethical guidelines in the clinical practice of fetal medicine are discussed, largely from the point of view of early prenatal diagnosis. The discussion concentrates on several specific aspects including counselling, good procedure, prenatal screening, disclosure of results including fetal sex, experimentation and assessment of new technologies and health education. ...

The practice of forensic pathology finds itself in the unenviable position of existing in a political environment, the existence of which depends upon compromise. The professional pathologist cannot compromise ethically, morally, or legally. As a practical fact of life, most of us find ourselves in the compromising position and with ...

This article identifies the ethical principles that have guided medicine since antiquity: beneficence, primum non nocere, patient autonomy, and respect for life and the quality of life. The author's basic premise is that many recently publicized ethical dilemmas are really not dilemmas--the knowledge of what is good or evil is ...

This paper develops two divergent views of occupational medicine. The first holds that the field has a major contribution to make in the prevention of disease and the stabilization of health care costs. The second sees in it all the worst characteristics of contemporary medical practice. Consideration of the special ...

This article summarizes current knowledge about the medicinal value of cannabis and its principal psychoactive ingredient, delta 9-tetrahydrocannabinol (THC), particularly in the control of nausea and vomiting, in glaucoma, and in reduction of spasticity in multiple sclerosis. The major issues in the controversy about marijuana and medicine, primarily moral and ...

The Therapeutic Recreation (TR) profession is obligated to articulate the ethics of its practice and to develop an ethical code to guide its conduct. The principles of bioethics and the rules of moral conduct derived from them are presented as a foundation for examining the ethical dimensions of TR practice ...

Ethical problems in clinical practice arise when clinicians confront competing value systems. Historically, behaviour therapy has been criticized because of alleged special ethical, moral and legal problems. These problems are no greater or smaller than in other forms of psychotherapeutic practice. But they can differ in emphasis. This article describes ...

Sashkin presents a model of participative management and contends that when value biases are absent and the need for skillful application and management are taken into account, participative management is effective. When properly implemented, participative management fulfills three basic human work needs--the need for autonomy or control over one's behavior, ...

The purpose of medical activities receives variegated interpretations that affect ethical and metamedical issues. Preservation of health and removal of disease are not acceptable goals of medicine, for they have such strong social components, that medicine would be more at the service of society than of the individual. Preservation of ...

Recent advances in biomedical technology and therapeutic procedures have generated a moral crisis in modern medicine. The vast strides made in medical science and technology have created options which only a few decades earlier would have been relegated to the realm of science fiction. Man, to a significant degree, now ...

There has been an overwhelming increase in scientific methods which has improved the practice of medicine. On the other hand, the costs have sky-rocketed to a point that we must ask ourselves, "Is this procedure sufficiently beneficial to warrant the expense?" Serious ethical and moral, as well as therapeutic, issues ...

Much has been written by many distinguished persons about the philosophical, religious and ethical considerations of doctors and their involvement with torture. What follows will not have the erudition or authority of the likes of St Augustine, Mahatma Gandi, Schopenhauer or Thomas Paine. It represents the views of a very ...

The scientific basis of the clinical evaluation of medicines is well established, and clinical investigators have also given considerable attention to the ethical problems. But of recent years there has been increasing concern with and criticism of the ethics of these procedures. Lawyers, medical doctors and others have expressed the ...

The ethics of defensive medicine, as distinguished from unnecessary testing for reasons other than fear of malpractice suits, and the usefulness its practice affords the physician in court are sharply questioned. Physicians, patients, and society are all adversely affected by its practice. Alternatives are recommended that physicians and organized medicine ...

The preservation and maintenance of natural park ecosystems, with modern man's being restricted to generally nonconsumptive uses of the park, represents one end of a spectrum of land use that extends through exploitation of natural ecosystems to the development of simplified agricultural ecosystems. Criteria for management of a park ecosystem ...

A case of alcoholism, often encountered in family practice, can illustrate some of the ethical issues that are inherent in the practice of medicine. The concepts of autonomy, paternalism, and beneficence are explored within the context of this clinical example. The nature of alcoholism, options for treatment, the unique circumstances ...

Capacity to consent is an area of practice that raises many ethical issues. The assessment by practitioners requires a flexible and creative approach. The Mental Capacity Bill is under final scrutiny by the House of Lords' committee and is intended to provide clearer guidance to focus practice in the future.

Emerging evidence suggests that media coverage of medicine is increasingly promotional in nature. Recent Australian examples include misleading newspaper articles on an experimental cancer vaccine and a high profile television current affairs segment on a new influenza drug, which failed to disclose the industry ties of a key expert featured ...

Medical service is needed in industry by both management and labor as never before. Industry is just beginning to awaken to this need. The medical profession is largely unaware of it. Unless physicians are prepared to heed this call, there is danger that management and labor will come to a ...