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Clinical ethics: a practical approach to ethical decisions in clinical medicine

New York: McGraw-Hill Education. Edited by Mark Siegler & William J. Winslade (2015)

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  1. A Reflection on Moral Distress in Nursing Together With a Current Application of the Concept.Andrew Jameton - 2013 - Journal of Bioethical Inquiry 10 (3):297-308.
    The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress—a common experience in complex societies—arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely (...)
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  • When Danny said no! Refusal of treatment by a patient of questionable competence.Joseph B. Moon & Glenn C. Graber - 1985 - Journal of Medical Humanities and Bioethics 6 (1):12-27.
    The patient we call Danny was a mildly mentally retarded male in his mid-thirties who adamantly refused kidney dialysis when it was offered as the only therapeutic option for his progressive kidney failure. It was uncertain how fully Danny understood the implications of his refusal. To complicate the case still further, several “advocates” emerged to speak on Danny's behalf — each with a somewhat different interpretation of the situation and different sets of value presuppositions and ethical principles to apply to (...)
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  • An Integrated Approach to Resource Allocation.Louise M. Terry - 2004 - Health Care Analysis 12 (2):171-180.
    Resource allocation decisions are often made on the basis of clinical and cost effectiveness at the expense of ethical inquiry into what is acceptable. This paper proposes that a more compassionate model of resource allocation would be achieved through integrating ethical awareness with clinical, financial and legal input. Where a publicly-funded healthcare system is involved, it is suggested that having an agency that focuses solely on cost-effectiveness leaving medical, legal and ethical considerations to others would help depoliticise rationing decisions and (...)
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  • Strangers at the benchside: Research ethics consultation.Mildred K. Cho, Sara L. Tobin, Henry T. Greely, Jennifer McCormick, Angie Boyce & David Magnus - 2008 - American Journal of Bioethics 8 (3):4 – 13.
    Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should (...)
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  • Ethics consultation in united states hospitals: A national survey.Ellen Fox, Sarah Myers & Robert A. Pearlman - 2007 - American Journal of Bioethics 7 (2):13 – 25.
    Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...)
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  • Practicing Neighbor Love: Empathy, Religion, and Clinical Ethics.Peter Bauck - 2023 - HEC Forum 35 (3):237-252.
    The role of religion in clinical ethics consultations is contested. The religion of the ethics consultant _can be_ an important part of the consultation process and improve the quality of a consultation. Practicing neighbor love leads to empathy, which not only can improve the quality of ethics consultations but also creates a space for religion to be part of, but not imposed on, the consultation. The practice of empathy will build trust, rapport, and an intersubjective connection that improves the quality (...)
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  • Friendship as a framework for resolving dilemmas in clinical ethics.Michal Pruski - 2021 - Monash Bioethics Review 39 (2):143-156.
    Healthcare professionals often need to make clinical decisions that carry profound ethical implications. As such, they require a tool that will make decision-making intuitive. While the discussion about the principles that should guide clinical ethics has been going on for over two thousand years, it does not seem that making such decisions is becoming any more straight forward. With an abundance of competing ethical systems and frameworks for their application in real life, the clinician is still often not sure how (...)
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  • Bioethicist as Partisan Ideologue.Mark J. Cherry - 2021 - American Journal of Bioethics 21 (6):22-25.
    Power tends to corrupt and absolute power corrupts absolutely. To be clear, I do not think that blood transfusions necessarily...
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  • Decision-making approaches in transgender healthcare: conceptual analysis and ethical implications.Karl Gerritse, Laura A. Hartman, Marijke A. Bremmer, Baudewijntje P. C. Kreukels & Bert C. Molewijk - 2021 - Medicine, Health Care and Philosophy 24 (4):687-699.
    Over the past decades, great strides have been made to professionalize and increase access to transgender medicine. As the evidence base grows and conceptualizations regarding gender dysphoria/gender incongruence evolve, so too do ideas regarding what constitutes good treatment and decision-making in transgender healthcare. Against this background, differing care models arose, including the ‘Standards of Care’ and the so-called ‘Informed Consent Model’. In these care models, ethical notions and principles such as ‘decision-making’ and ‘autonomy’ are often referred to, but left unsubstantiated. (...)
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  • Subsequent Consent and Blameworthiness.Jason Chen - 2020 - HEC Forum 32 (3):239-251.
    Informed consent is normally understood as something that a patient gives prior to a medical intervention that can render it morally permissible. Whether or not it must be given prior to the intervention is debated. Some have argued that subsequent consent—that is, consent given after a medical intervention—can also render an otherwise impermissible act permissible. If so, then a patient may give her consent to an intervention that has already been performed and thereby justify a physician’s act retroactively. The purpose (...)
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  • What the HEC-C? An Analysis of the Healthcare Ethics Consultant-Certified Program: One Year in.Janet Malek, Sophia Fantus, Andrew Childress & Claire Horner - 2020 - American Journal of Bioethics 20 (3):9-18.
    Efforts to professionalize the field of bioethics have led to the development of the Healthcare Ethics Consultant-Certified (HEC-C) Program intended to credential practicing healthcare ethics consultants (HCECs). Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the HEC-C Program to (...)
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  • Screenplays and Screenwriting as an Innovative Teaching Tool in Medical Ethics Education.Abbas Rattani & Abdul-Hadi Kaakour - 2019 - Journal of Medical Humanities 42 (4):679-687.
    Innovation in ethics pedagogy has continued to evolve and incorporate other forms of storytelling aimed at improving student engagement and learning. The use of bioethics narratives in feature-length films, medical television shows, or short clips in the classroom has a well-established history. In parallel, screenplays present an opportunity for an active approach to ethical engagement. We argue that screenplays and screenwriting provide a rich supplement to current medical ethics teaching and serve as a strong form of reflective learning.
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  • The ethical obligation of the dead donor rule.Anne L. Dalle Ave, Daniel P. Sulmasy & James L. Bernat - 2020 - Medicine, Health Care and Philosophy 23 (1):43-50.
    The dead donor rule (DDR) originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death (DCDD) programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We (...)
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  • “If an acute event occurs, what should we do?” Diverse ethical approaches to decision-making in the ICU.Federico Nicoli, Paul Cummins, Joseph A. Raho, Rouven Porz, Giulio Minoja & Mario Picozzi - 2019 - Medicine, Health Care and Philosophy 22 (3):475-486.
    The aim of this paper is to analyze an Intensive Care Unit case that required ethics consultation at a University Hospital in Northern Italy. After the case was resolved, a retrospective ethical analysis was performed by four clinical ethicists who work in different healthcare contexts. Each ethicist used a different method to analyze the case; the four general approaches provide insight into how these ethicists conduct ethics consultations at their respective hospitals. Concluding remarks examine the similarities and differences among the (...)
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  • Case Commentary: a Reflection on Ethical Dilemma in End-of-Life Care.Sue Wern Neoh - 2017 - Asian Bioethics Review 9 (1-2):129-135.
    This case report illustrates the complexity of managing a young patient with complications of diabetes mellitus and the ethical considerations in decision-making to withhold treatment. Mr. T suffered from poorly controlled type 1 diabetes mellitus with microvascular and macrovascular complications including nephropathy requiring long-term haemodialysis. He was admitted for necrotising suppurative tenosynovitis, which is a type of infection of tendon and synovium, of the right upper limb that led to sepsis and multi-organ dysfunction despite antibiotics and multiple debridements or surgeries. (...)
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  • Philosophers' Invasion of Clinical Ethics: Historical and Personal Reflections.Robert Baker - 2018 - American Journal of Bioethics 18 (6):51-54.
    When laypeople learned what decisions physicians were making about laypeople's health they were often appalled. … They discovered that physicians … were making controversial moral moves, choices th...
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  • Getting the Story Straight: Clinical Ethics as a Distinctive Field.Kristina Orfali - 2018 - American Journal of Bioethics 18 (6):62-64.
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  • Confidentiality breaches in clinical practice: what happens in hospitals?Cristina M. Beltran-Aroca, Eloy Girela-Lopez, Eliseo Collazo-Chao, Manuel Montero-Pérez-Barquero & Maria C. Muñoz-Villanueva - 2016 - BMC Medical Ethics 17 (1):52.
    BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...)
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  • Perception of Palliative Care and Euthanasia Among Recently Graduated and Experienced Nurses.Tomasz Brzostek, Wim Dekkers, Zbigniew Zalewski, Anna Januszewska & Maciej Górkiewicz - 2008 - Nursing Ethics 15 (6):761-776.
    Palliative care and euthanasia have become the subject of ethical and political debate in Poland. However, the voice of nurses is rarely heard. The aim of this study is to explore the perception of palliative care and euthanasia among recent university bachelor degree graduates and experienced nurses in Poland. Specific objectives include: self-assessment of the understanding of these terms, recognition of clinical cases, potential acceptability of euthanasia, and an evaluation of attitudes towards palliative care and euthanasia. This is an exploratory (...)
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  • Exploring the similarities and differences between medical assessments of competence and criminal responsibility.Gerben Meynen - 2009 - Medicine, Health Care and Philosophy 12 (4):443-451.
    The medical assessments of criminal responsibility and competence to consent to treatment are performed, developed and debated in distinct domains. In this paper I try to connect these domains by exploring the similarities and differences between both assessments. In my view, in both assessments a decision-making process is evaluated in relation to the possible influence of a mental disorder on this process. I will argue that, in spite of the relevance of the differences, both practices could benefit from the recognition (...)
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  • Human Health and the Environment: In Harmony or in Conflict? [REVIEW]David B. Resnik - 2009 - Health Care Analysis 17 (3):261-276.
    Health policy frameworks usually construe environmental protection and human health as harmonious values. Policies that protect the environment, such as pollution control and pesticide regulation, also benefit human health. In recent years, however, it has become apparent that promoting human health sometimes undermines environmental protection. Some actions, policies, or technologies that reduce human morbidity, mortality, and disease can have detrimental effects on the environment. Since human health and environmental protection are sometimes at odds, political leaders, citizens, and government officials need (...)
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  • Complex Hospital Discharges: Justice Considered. [REVIEW]Maura C. Schlairet - 2014 - HEC Forum 26 (1):69-78.
    How do we respond to the patient who no longer needs inpatient care but refuses to leave the hospital? Complex hospital discharges commonly involve consideration of legal, financial, clinical, and practical issues. Yet, the ethical and contextual issues embedded in complex inpatient discharges are of concern and have not received adequate attention by medical ethicists. The aim of this work is to encourage clinicians and administrators to incorporate a justice rubric when approaching inpatient discharge dilemmas. This paper presents justice as (...)
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  • Strategic Maneuvering in Treatment Decision-Making Discussions: Two Cases in Point. [REVIEW]Nanon Labrie - 2012 - Argumentation 26 (2):171-199.
    Over the past decade, the ideal model of shared decision-making has been increasingly promoted as the preferred standard of doctor-patient communication in medical consultation. The model advocates a treatment decision-making process in which the doctor and his patient are considered coequal partners that carefully negotiate the treatment options available in order to ultimately reach a treatment decision that is mutually shared. Thereby, the model notably leaves room for—and stimulates—argumentative discussions to arise in the context of medical consultation. A paradigm example (...)
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  • The Moral Domain of the Medical Record: The Routine Ethics Evaluation.Alfred I. Tauber - 2006 - American Journal of Bioethics 6 (4):W1-W16.
    The structure, content, and orientation of the contemporary medical record inadequately reflect the appropriate influence of patients' rights and bioethics on health care. Most tellingly, the medical chart reveals a remarkable absence of attention to medical ethics, except in the case of crisis management. But medical ethics informs both crisis decision-making and virtually all clinical interventions. Indeed, clinical care embodies a complex array of choices influenced by individual and cultural values, themselves reflecting religious beliefs, personal histories, psychologies, and social mores. (...)
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  • Compounding Vulnerability: Pregnancy and Schizophrenia.Denise M. Dudzinski - 2006 - American Journal of Bioethics 6 (2):W1-W14.
    The predominant ethical framework for addressing reproductive decisions in the maternal–fetal relationship is respect for the woman's autonomy. However, when a pregnant schizophrenic woman lacks such autonomy, healthcare providers try to both protect her and respect her preferences. By delineating etic (objective) and emic (subjective) perspectives on vulnerability, I argue that options which balance both perspectives are preferable and that acting on etic perspectives to the exclusion of emic considerations is rarely justified. In negotiating perspectives, we balance the etic commitment (...)
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  • A Narrative Approach to the Clinical Reasoning Process in Pediatric Intensive Care: The Story of Matthew.Michele A. Carter & Sally S. Robinson - 2001 - Journal of Medical Humanities 22 (3):173-194.
    This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool—a dialogical (...)
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  • HEC member perspectives on the case analysis process: A qualitative multi-site study. [REVIEW]Eric Racine - 2007 - HEC Forum 19 (3):185-206.
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  • Violations of service fairness and legal ramifications: The case of the managed care industry. [REVIEW]Marjorie Chan - 2002 - Journal of Business Ethics 36 (4):315 - 336.
    Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with (...)
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  • Clinical ethics consultations: a scoping review of reported outcomes.Ann M. Heesters, Ruby R. Shanker, Kevin Rodrigues, Daniel Z. Buchman, Andria Bianchi, Claudia Barned, Erica Nekolaichuk, Eryn Tong, Marina Salis & Jennifer A. H. Bell - 2022 - BMC Medical Ethics 23 (1):1-65.
    BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...)
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  • Do we understand the intervention? What complex intervention research can teach us for the evaluation of clinical ethics support services.Jan Schildmann, Stephan Nadolny, Joschka Haltaufderheide, Marjolein Gysels, Jochen Vollmann & Claudia Bausewein - 2019 - BMC Medical Ethics 20 (1):48.
    Evaluating clinical ethics support services has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. In this paper, we argue that a first necessary step for progress is to better understand the intervention in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, we (...)
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  • Beyond medical ethics: New directions for philosophy and medicine.Raphael Sassower & Michael A. Grodin - 1988 - Journal of Medical Humanities and Bioethics 9 (2):121-134.
    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. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the social cultural (...)
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  • Autonomy and the Moral Authority of Advance Directives.Eric Vogelstein - 2016 - Journal of Medicine and Philosophy 41 (5):500-520.
    Although advance directives are widely believed to be a key way to safeguard the autonomy of incompetent medical patients, significant questions exist about their moral authority. The main philosophical concern involves cases in which an incompetent patient no longer possesses the desires on which her advance directive was based. The question is, does that entail that prior expressions of medical choices are no longer morally binding? I believe that the answer is “yes.” I argue that a patient’s autonomy is not (...)
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  • Models of Ethics Consultation Used by Canadian Ethics Consultants: A Qualitative Study.Chris Kaposy, Fern Brunger, Victor Maddalena & Richard Singleton - 2016 - HEC Forum 28 (4):273-282.
    This article describes a qualitative study of models of ethics consultation used by ethics consultants in Canada. We found four different models used by Canadian ethics consultants whom we interviewed, and one sub-variant. We describe the lone ethics consultant model, the hub-and-spokes sub-variant of this model; the ethics committee model; the capacity-building model; and the facilitated model. Previous empirical studies of ethics consultation describe only two or three of these models.
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  • Good and not so good medical ethics.Rosamond Rhodes - 2015 - Journal of Medical Ethics 41 (1):71-74.
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  • Ethical decision making in dental education: a preliminary study.Mehmet İlgüy, Dilhan İlgüy & İnci Oktay - 2015 - BMC Medical Ethics 16 (1):1-6.
    BackgroundIn terms of ethical decision making, every clinical case, when seen as an ethical problem, may be analyzed by means of four topics: medical indications, patient preferences, quality of life, contextual features. The aim of this study was to compare the performance of 4th year dental students on Ethical Decision Making before and after a course on ethics.MethodsFourth year dental students from academic year 2013–2014 participated in the study. A 3-h lecture, which was about four topics approach to clinical ethical (...)
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  • Attitudes of physicians and patients towards disclosure of genetic information to spouse and first-degree relatives: a case study from Turkey.Aslihan Akpinar & Nermin Ersoy - 2014 - BMC Medical Ethics 15 (1):39.
    When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.
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  • Debating Ethical Expertise.Norbert L. Steinkamp, Bert Gordijn & Henk A. M. J. ten Have - 2008 - Kennedy Institute of Ethics Journal 18 (2):173-192.
    This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception (...)
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  • Deciding for a child: a comprehensive analysis of the best interest standard. [REVIEW]Erica K. Salter - 2012 - Theoretical Medicine and Bioethics 33 (3):179-198.
    This article critically examines, and ultimately rejects, the best interest standard as the predominant, go-to ethical and legal standard of decision making for children. After an introduction to the presumption of parental authority, it characterizes and distinguishes six versions of the best interest standard according to two key dimensions related to the types of interests emphasized. Then the article brings three main criticisms against the best interest standard: (1) that it is ill-defined and inconsistently appealed to and applied, (2) that (...)
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  • Pharmaceutical enhancement and medical professionals.Gavin G. Enck - 2014 - Medicine, Health Care and Philosophy 17 (1):23-28.
    Emerging data indicates the prevalence and increased use of pharmaceutical enhancements by young medical professionals. As pharmaceutical enhancements advance and become more readily available, it is imperative to consider their impact on medical professionals. If pharmaceutical enhancements augment a person’s neurological capacities to higher functioning levels, and in some situations having higher functioning levels of focus and concentration could improve patient care, then might medical professionals have a responsibility to enhance? In this paper, I suggest medical professionals may have a (...)
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  • In Search of an Honest Case.Mark G. Kuczewski - 2001 - American Journal of Bioethics 1 (1):44-45.
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  • What triggers requests for ethics consultations?G. DuVal - 2001 - Journal of Medical Ethics 27 (suppl 1):24-29.
    Objectives—While clinical practice is complicated by many ethical dilemmas, clinicians do not often request ethics consultations. We therefore investigated what triggers clinicians' requests for ethics consultation. Design—Cross-sectional telephone survey.Setting—Internal medicine practices throughout the United States.Participants—Randomly selected physicians practising in internal medicine, oncology and critical care.Main measurements—Socio-demographic characteristics, training in medicine and ethics, and practice characteristics; types of ethical problems that prompt requests for consultation, and factors triggering consultation requests. Results—One hundred and ninety of 344 responding physicians (55%) reported requesting ethics (...)
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  • Intuition and the junctures of judgment in decision procedures for clinical ethics.John K. Davis - 2007 - Theoretical Medicine and Bioethics 28 (1):1-30.
    Moral decision procedures such as principlism or casuistry require intuition at certain junctures, as when a principle seems indeterminate, or principles conflict, or we wonder which paradigm case is most relevantly similar to the instant case. However, intuitions are widely thought to lack epistemic justification, and many ethicists urge that such decision procedures dispense with intuition in favor of forms of reasoning that provide discursive justification. I argue that discursive justification does not eliminate or minimize the need for intuition, or (...)
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  • Discussions on Present Japanese Psychocultural-Social Tendencies as Obstacles to Clinical Shared Decision-Making in Japan.Seiji Bito, Taketoshi Okita & Atsushi Asai - 2022 - Asian Bioethics Review 14 (2):133-150.
    In Japan, where a prominent gap exists in what is considered a patient’s best interest between the medical and patient sides, appropriate decision-making can be difficult to achieve. In Japanese clinical settings, decision-making is considered an act of choice-making from multiple potential options. With many ethical dilemmas still remaining, establishing an appropriate decision-making process is an urgent task in modern Japanese healthcare. This paper examines ethical issues related to shared decision-making (SDM) in clinical settings in modern Japan from the psychocultural-social (...)
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  • Health care ethics programs in U.S. Hospitals: results from a National Survey.Christopher C. Duke, Anita Tarzian, Ellen Fox & Marion Danis - 2021 - BMC Medical Ethics 22 (1):1-14.
    BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...)
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  • Making the (Business) Case for Clinical Ethics Support in the UK.L. L. Machin & Mark Wilkinson - 2020 - HEC Forum 33 (4):371-391.
    This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, (...)
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  • The last low whispers of our dead: when is it ethically justifiable to render a patient unconscious until death?Daniel P. Sulmasy - 2018 - Theoretical Medicine and Bioethics 39 (3):233-263.
    A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: double-effect sedation, parsimonious direct sedation, and sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices (...)
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  • Were the “Pioneer” Clinical Ethics Consultants “Outsiders”? For Them, Was “Critical Distance” That Critical?Bruce D. White, Wayne N. Shelton & Cassandra J. Rivais - 2018 - American Journal of Bioethics 18 (6):34-44.
    “Clinical ethics consultants” have been practicing in the United States for about 50 years. Most of the earliest consultants—the “pioneers”—were “outsiders” when they first appeared at patients' bedsides and in the clinic. However, if they were outsiders initially, they acclimated to the clinical setting and became “insiders” very quickly. Moreover, there was some tension between traditional academics and those doing applied ethics about whether there was sufficient “critical distance” for appropriate reflection about the complex medical ethics dilemmas of the day (...)
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  • Ethical Issues in Patients with Leukemia: Practice Points and Educational Topics for the Clinical Oncologist and Trainees.Jeffery S. Farroni, Phillp A. Thompson, Daud Arif, Jorge E. Cortes & Colleen M. Gallagher - 2017 - Journal of Clinical Research and Bioethics 8 (5).
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  • Values‐based practice and bioethics: close friends rather than distant relatives. Commentary on 'Fulford (2011). The value of evidence and evidence of values: bringing together values‐based and evidence‐based practice in policy and service development in mental health'.Mona Gupta - 2011 - Journal of Evaluation in Clinical Practice 17 (5):992-995.
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  • Ethik in der klinischen Medizin: Bestandsaufnahme und Ausblick.Jochen Vollmann - 2006 - Ethik in der Medizin 18 (4):348-352.
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