In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

Shows how the ethical issues raised by secrets and secrecy in our careers or private lives take us to the heart of the critical questions of private and public morality.

A survey form sent to psychologists (Pope, Keith-Spiegel, & Tabachnick, 1986) was adapted and sent to 1,000 clinical social workers (return rate = 45%). Most participants reported sexual attraction to a client, causing (for most) guilt, anxiety, or confusion. Some reported having sexual fantasies about a client while engaging in sex with someone other than a client. Relatively few (3.6% men; 0.5% women) reported sex with a client; training was related to likelihood of offending, though the effect is small and (...) complex. An analysis of eight national studies (data from 5,148 therapists) found significant effects for gender (more male offenders) and year of study (about 10% annual decrease in reported offenses since 1977) but not profession (i.e., no difference among psychiatrists, psychologists, and social workers). Most social workers reported no graduate training whatsoever about sexual attraction; only 10% reported adequate training. (shrink)

The 1980s heralded the beginning of an awareness of sexual exploitation of clients by health care professionals and clergy. The focus then was on raising consciousness about the problem. This volume reflects the concerns of the 1990s: it explores the subject in greater depth, develops theoretical ties to other areas and proposes sophisticated solutions. Following an introductory overview, Breach of Trust focuses on victims. Contributions include victims' first-hand accounts and discussions of support and recovery groups and individual therapy for both (...) male and female victims and their families. The contributors then examine perpetrators: they describe innovative work being undertaken to understand the characteristics. (shrink)

Too often, caregivers and ethicists misunderstand the motivations of adult children who are involved in the care of their parents. They sometimes fail to appreciate the ways in which adult children may be trying to carry out their filial obligations toward a parent, obligations dictated by their religious commitments. Exploring these obligations within the Jewish tradition can help to illuminate these issues and provide an alternative to a rights‐based framework in which to reason about them.

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way to (...) a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)