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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. 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • Cardiovascular medicine at face value: a qualitative pilot study on clinical axiology.Adalberto de Hoyos, Rodrigo Nava-Diosdado, Jorge Mendez, Sergio Ricco, Ana Serrano, Carmen Flores Cisneros, Carlos Macías-Ojeda, Héctor Cisneros, David Bialostozky, Nelly Altamirano-Bustamante & Myriam Altamirano-Bustamante - 2013 - Philosophy, Ethics, and Humanities in Medicine 8:3.
    Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they (...)
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  • Ethical considerations for performing decompressive craniectomy as a life-saving intervention for severe traumatic brain injury.Stephen Honeybul, Grant Gillett, Kwok Ho & Christopher Lind - 2012 - Journal of Medical Ethics 38 (11):657-661.
    In all fields of clinical medicine, there is an increasing awareness that outcome must be assessed in terms of quality of life and cost effectiveness, rather than merely length of survival. This is especially the case when considering decompressive craniectomy for severe traumatic brain injury. The procedure itself is technically straightforward and involves temporarily removing a large section of the skull vault in order to provide extra space into which the injured brain can expand. A number of studies have demonstrated (...)
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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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  • 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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  • Re-Framing Moral Distress to Benefit Both Patient and Caregiver.Mark Repenshek & Emily Trancik - 2024 - American Journal of Bioethics 24 (1):137-139.
    Mr. Rivers’ case offers an example of how a caregiver may perceive the concept of moral distress. The nurse is experiencing what is described as moral distress at the prospect of participating in C...
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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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  • 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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  • Good enough? Parental decisions to use DIY looping technology to manage type 1 diabetes in children.Carolyn Johnston - 2021 - Monash Bioethics Review 39 (Suppl 1):26-41.
    People are using innovative internet of things technologies to gain individualised management of their type 1 diabetes. The #WeAreNotWaiting movement supports them to build their own hybrid closed loop systems and access their real time blood sugar data via any web connected device. A small number of parents in Australia use such DIY looping systems to manage their child’s type 1 diabetes, but these systems have not been approved by the Therapeutic Goods Administration in Australia, creating ethical dilemmas for clinicians (...)
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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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  • Strangers at the Altar.Ana Iltis - 2021 - American Journal of Bioethics 21 (6):19-22.
    “Outsiders” addressing ethical issues in medicine—Strangers at the Bedside —became “bioethicists.” Bioethicists providing research ethics consultation have been described as “stranger...
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  • What is the appropriate role of reason in secular clinical ethics? An argument for a compatibilist view of public reason.Abram Brummett - 2021 - Medicine, Health Care and Philosophy 24 (2):281-290.
    This article describes and rejects three standard views of reason in secular clinical ethics. The first, instrumental reason view, affirms that reason may be used to draw conceptual distinctions, map moral geography, and identify invalid forms of argumentation, but prohibits recommendations because reason cannot justify any content-full moral or metaphysical commitments. The second, public reason view, affirms instrumental reason, and claims ethicists may make recommendations grounded in the moral and metaphysical commitments of bioethical consensus. The third, comprehensive reason view, also (...)
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  • Culpable Ignorance, Professional Counselling, and Selective Abortion of Intellectual Disability.James B. Gould - 2020 - Journal of Bioethical Inquiry 17 (3):369-381.
    In this paper I argue that selective abortion for disability often involves inadequate counselling on the part of reproductive medicine professionals who advise prospective parents. I claim that prenatal disability clinicians often fail in intellectual duty—they are culpably ignorant about intellectual disability. First, I explain why a standard motivation for selective abortion is flawed. Second, I summarize recent research on parent experience with prenatal professionals. Third, I outline the notions of epistemic excellence and deficiency. Fourth, I defend culpable ignorance as (...)
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  • Casuistry: On a Method of Ethical Judgement in Patient Care.Bernhard Bleyer - 2020 - HEC Forum 32 (3):211-226.
    The article is dedicated to the application questions of a case study method known as casuistry. In its long tradition, it focuses on an influential variant of the early modern period and reconstructs its functionality. In the course of reading recent receptions, it is noted that some studies speak of a “casuistic revival” in moral case deliberation in health care. As a result of this revival, casuistry has been modified in such a way that it guides case discussions in practice (...)
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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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  • 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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  • 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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  • 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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  • 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.
    Abstract“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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  • The ethics of caring for hospital-dependent patients.Calvin Sung & Jennifer L. Herbst - 2017 - BMC Medical Ethics 18 (1):75.
    Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis. It is (...)
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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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  • Should physicians tell the truth without taking social complications into account? A striking case.Ercan Avci - 2018 - Medicine, Health Care and Philosophy 21 (1):23-30.
    The principle of respect for autonomy requires informing patients adequately and appropriately about diagnoses, treatments, and prognoses. However, some clinical cases may cause ethical dilemmas regarding telling the truth. Under the existence especially of certain cultural, social, and religious circumstances, disclosing all the relevant information to all pertinent parties might create harmful effects. Even though the virtue of telling the truth is unquestionable, sometimes de facto conditions compel physicians to act paternalistically to protect the patient/patients from imminent dangers. This article, (...)
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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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  • 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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  • Examining the Root Cause of Surrogate Conflicts in the Intensive Care Unit and General Wards.Katrina A. Bramstedt & Allison Neyhart Rubin - 2010 - Monash Bioethics Review 29 (1):38-48.
    This study is an analysis of surrogate-focused ethics consultations in the Intensive Care Unit (ICU) and the general wards (Ward) of a large community hospital in Northern California. We identified the major themes of surrogate-focused ethics consultations to better understand the root cause of surrogate conflicts, and identified the similarities and differences between surrogate-based conflicts in the two settings. Consults requested because the surrogate had desires that conflicted with the physicians medical opinion of ‘best interest’, or cases involving surrogates not (...)
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  • 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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  • 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 Little Bit of Heaven for a Few? A Case Analysis.Ann Gallagher & Nigel Sykes - 2008 - Ethics and Social Welfare 2 (3):299-307.
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  • Ethical case deliberation on the ward. A comparison of four methods.Norbert Steinkamp & Bert Gordijn - 2003 - Medicine, Health Care and Philosophy 6 (3):235-246.
    The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one (...)
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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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  • 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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  • Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists.Trevor M. Bibler - 2023 - HEC Forum 35 (4):309-323.
    Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers (...)
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  • A New Perspective on Challenges in Truth-telling to Patients.Jannat Mashayekhi, Saeedeh Saeedi Tehrani & Mohsen Rezaei Adaryani - 2021 - Health, Spirituality and Medical Ethics 8 (2):133-140.
    Background and Objectives: Patient autonomy is a recognized principle in modern medical ethics, and truth-telling to the patient; thus, it holds special importance for its contribution to this principle. In practice, however, several challenges emerge that can lead to different responses. This difference is more marked in studies conducted in the Eastern and Muslim countries due to variations in cultural and religious beliefs. Truth-telling is a challenging concept respecting placebos, medical errors, and delivering bad news on diagnosis and treatment to (...)
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  • The Hidden Curriculum and Integrating Cure- and Care-Based Approaches to Medicine.Divya Choudhury & Nico Nortjé - 2020 - HEC Forum 34 (1):41-53.
    Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum (...)
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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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  • Embedding Ethics Education in Clinical Clerkships by Identifying Clinical Ethics Competencies: The Vanderbilt Experience.Alexander Langerman, William B. Cutrer, Elizabeth Ann Yakes & Keith G. Meador - 2020 - HEC Forum 32 (2):163-174.
    The clinical clerkships in medical school are the first formal opportunity for trainees to apply bioethics concepts to clinical encounters. These clerkships are also typically trainees’ first sustained exposure to the “reality” of working in clinical teams and the full force of the challenges and ethical tensions of clinical care. We have developed a specialized, embedded ethics curriculum for Vanderbilt University medical students during their second year to address the unique experience of trainees’ first exposure to clinical care. Our embedded (...)
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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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  • What Do Students Perceive as Ethical Problems? A Comparative Study of Dutch and Indonesian Medical Students in Clinical Training.Amalia Muhaimin, Derk Ludolf Willems, Adi Utarini & Maartje Hoogsteyns - 2019 - Asian Bioethics Review 11 (4):391-408.
    Previous studies show that medical students in clinical training face ethical problems that are not often discussed in the literature. In order to make teaching timely and relevant for them, it is important to understand what medical students perceive as ethical problems, as various factors may influence their perception, including cultural differences and working environment. The purpose of this qualitative study was to explore students’ perceptions of what an ethical problem is, during their clinical training in the hospital, and compare (...)
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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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  • Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation.Hui Jin Toh, James Alvin Low, Zhen Yu Lim, Yvonne Lim, Shahla Siddiqui & Lawrence Tan - 2018 - Asian Bioethics Review 10 (1):37-51.
    This was an in-depth qualitative study that looked at the reasons patients were referred to the Clinical Ethics Committee of an acute hospital in Singapore and explore how the CEC approached cases referred. Jonsen’s four topics approach was applied in the deliberative process for all cases. A comprehensive review of the case records of 28 patients referred consecutively to the CEC from 1 January 2012 to 31 December 2014 was conducted. Data and information was collated from the referral forms, patient (...)
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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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  • 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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  • 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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