File Name: medical law and ethics textbook .zip
Law has played a critical role in the great public health achievements of the past century, including vaccination, seat belt use, water fluoridation, and tobacco control. Public health ethics can provide a structure for determining which of the permissible actions authorized by law should be taken.
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Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy , non-maleficence, beneficence , and justice. There are several codes of conduct. The Hippocratic Oath discusses basic principles for medical professionals. Other important markings in the history of medical ethics include Roe v.
Wade in and the development of hemodialysis in the s. More recently, new techniques for gene editing aiming at treating, preventing and curing diseases utilizing gene editing, are raising important moral questions about their applications in medicine and treatments as well as societal impacts on future generations. As this field continues to develop and change throughout history, the focus remains on fair, balanced, and moral thinking across all cultural and religious backgrounds around the world.
Medical ethics encompasses beneficence, autonomy, and justice as they relate to conflicts such as euthanasia, patient confidentiality, informed consent, and conflicts of interest in healthcare. This leads to an increasing need for culturally sensitive physicians and ethical committees in hospitals and other healthcare settings. The term medical ethics first dates back to , when English author and physician Thomas Percival published a document describing the requirements and expectations of medical professionals within medical facilities.
The Code of Ethics was then adapted in , relying heavily on Percival's words. Historically, Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath , and early Christian teachings.
The first code of medical ethics, Formula Comitis Archiatrorum , was published in the 5th century, during the reign of the Ostrogothic king Theodoric the Great. In the medieval and early modern period, the field is indebted to Islamic scholarship such as Ishaq ibn Ali al-Ruhawi who wrote the Conduct of a Physician , the first book dedicated to medical ethics , Avicenna 's Canon of Medicine and Muhammad ibn Zakariya ar-Razi known as Rhazes in the West , Jewish thinkers such as Maimonides , Roman Catholic scholastic thinkers such as Thomas Aquinas , and the case-oriented analysis casuistry of Catholic moral theology.
These intellectual traditions continue in Catholic , Islamic and Jewish medical ethics. By the 18th and 19th centuries, medical ethics emerged as a more self-conscious discourse. In England, Thomas Percival , a physician and author, crafted the first modern code of medical ethics. He drew up a pamphlet with the code in and wrote an expanded version in , in which he coined the expressions "medical ethics" and "medical jurisprudence".
Jeffrey Berlant is one such critic who considers Percival's codes of physician consultations as being an early example of the anti-competitive, "guild"-like nature of the physician community. It introduced compulsory apprenticeship and formal qualifications for the apothecaries of the day under the license of the Society of Apothecaries.
This was the beginning of regulation of the medical profession in the UK. In , the American Medical Association adopted its first code of ethics , with this being based in large part upon Percival's work.
In the s and s, building upon liberal theory and procedural justice , much of the discourse of medical ethics went through a dramatic shift and largely reconfigured itself into bioethics. Since the s, the growing influence of ethics in contemporary medicine can be seen in the increasing use of Institutional Review Boards to evaluate experiments on human subjects, the establishment of hospital ethics committees, the expansion of the role of clinician ethicists, and the integration of ethics into many medical school curricula.
A common framework used in the analysis of medical ethics is the "four principles" approach postulated by Tom Beauchamp and James Childress in their textbook Principles of biomedical ethics. It recognizes four basic moral principles, which are to be judged and weighed against each other, with attention given to the scope of their application. The four principles are: . The principle of autonomy , broken down into "autos" self and "nomos rule , views the rights of an individual to self-determination.
Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient and their family rather than medical professionals. The definition of autonomy is the ability of an individual to make a rational, uninfluenced decision.
Therefore, it can be said that autonomy is a general indicator of a healthy mind and body. The progression of many terminal diseases are characterized by loss of autonomy, in various manners and extents. For example, dementia , a chronic and progressive disease that attacks the brain can induce memory loss and cause a decrease in rational thinking, almost always results in the loss of autonomy.
Psychiatrists and clinical psychologists are often asked to evaluate a patient's capacity for making life-and-death decisions at the end of life. Persons with a psychiatric condition such as delirium or clinical depression may lack capacity to make end-of-life decisions. For these persons, a request to refuse treatment may be taken in the context of their condition. Unless there is a clear advance directive to the contrary, persons lacking mental capacity are treated according to their best interests.
This will involve an assessment involving people who know the person best to what decisions the person would have made had they not lost capacity. Psychiatrists and psychologists may be involved to support decision making.
The term beneficence refers to actions that promote the well being of others. In the medical context, this means taking actions that serve the best interests of patients and their families.
James Childress and Tom Beauchamp in Principle of Biomedical Ethics identify beneficence as one of the core values of healthcare ethics. Some scholars, such as Edmund Pellegrino , argue that beneficence is the only fundamental principle of medical ethics.
They argue that healing should be the sole purpose of medicine, and that endeavors like cosmetic surgery and euthanasia are severely unethical and against the Hippocratic Oath. The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration hence primum : that it is more important not to harm your patient, than to do them good, which is part of the Hippocratic oath that doctors take.
Much harm has been done to patients as a result, as in the saying, "The treatment was a success, but the patient died. In practice, however, many treatments carry some risk of harm. In some circumstances, e. So the principle of non-maleficence is not absolute, and balances against the principle of beneficence doing good , as the effects of the two principles together often give rise to a double effect further described in next section. Even basic actions like taking a blood sample or an injection of a drug cause harm to the patient's body.
Euthanasia also goes against the principle of beneficence because the patient dies as a result of the medical treatment by the doctor. Double effect refers to two types of consequences that may be produced by a single action,  and in medical ethics it is usually regarded as the combined effect of beneficence and non-maleficence. A commonly cited example of this phenomenon is the use of morphine or other analgesic in the dying patient.
Such use of morphine can have the beneficial effect of easing the pain and suffering of the patient while simultaneously having the maleficent effect of shortening the life of the patient through the deactivation of the respiratory system. The human rights era started with the formation of the United Nations in , which was charged with the promotion of human rights. The Universal Declaration of Human Rights was the first major document to define human rights. Medical doctors have an ethical duty to protect the human rights and human dignity of the patient so the advent of a document that defines human rights has had its effect on medical ethics.
The Council of Europe promotes the rule of law and observance of human rights in Europe. The Council of Europe adopted the European Convention on Human Rights and Biomedicine to create a uniform code of medical ethics for its 47 member-states. The Convention applies international human rights law to medical ethics. It provides special protection of physical integrity for those who are unable to consent, which includes children. No organ or tissue removal may be carried out on a person who does not have the capacity to consent under Article 5.
As of December , the Convention had been ratified or acceded to by twenty-nine member-states of the Council of Europe. Like recommendations, they set forth universal principles to which the community of States wished to attribute the greatest possible authority and to afford the broadest possible support.
The Declaration provides special protection of human rights for incompetent persons. In applying and advancing scientific knowledge, medical practice and associated technologies, human vulnerability should be taken into account.
Individuals and groups of special vulnerability should be protected and the personal integrity of such individuals respected. Individualistic standards of autonomy and personal human rights as they relate to social justice seen in the Anglo-Saxon community, clash with and can also supplement the concept of solidarity, which stands closer to a European healthcare perspective focused on community, universal welfare, and the unselfish wish to provide healthcare equally for all.
The concept of normality, that there is a human physiological standard contrasting with conditions of illness, abnormality and pain, leads to assumptions and bias that negatively affects health care practice. Autonomy can come into conflict with beneficence when patients disagree with recommendations that healthcare professionals believe are in the patient's best interest. When the patient's interests conflict with the patient's welfare, different societies settle the conflict in a wide range of manners.
In general, Western medicine defers to the wishes of a mentally competent patient to make their own decisions, even in cases where the medical team believes that they are not acting in their own best interests.
However, many other societies prioritize beneficence over autonomy. Examples include when a patient does not want a treatment because of, for example, religious or cultural views. In the case of euthanasia , the patient, or relatives of a patient, may want to end the life of the patient. Also, the patient may want an unnecessary treatment , as can be the case in hypochondria or with cosmetic surgery ; here, the practitioner may be required to balance the desires of the patient for medically unnecessary potential risks against the patient's informed autonomy in the issue.
A doctor may want to prefer autonomy because refusal to please the patient's self-determination would harm the doctor-patient relationship.
Organ donations can sometimes pose interesting scenarios, in which a patient is classified as a non-heart beating donor NHBD , where life support fails to restore the heartbeat and is now considered futile but brain death has not occurred.
Classifying a patient as a NHBD can qualify someone to be subject to non-therapeutic intensive care, in which treatment is only given to preserve the organs that will be donated and not to preserve the life of the donor. This can bring up ethical issues as some may see respect for the donors wishes to donate their healthy organs as respect for autonomy, while others may view the sustaining of futile treatment during vegetative state maleficence for the patient and the patient's family.
Some are worried making this process a worldwide customary measure may dehumanize and take away from the natural process of dying and what it brings along with it. Individuals' capacity for informed decision-making may come into question during resolution of conflicts between autonomy and beneficence.
The role of surrogate medical decision-makers is an extension of the principle of autonomy. For example, a breach of patients' autonomy may cause decreased confidence for medical services in the population and subsequently less willingness to seek help, which in turn may cause inability to perform beneficence. There is disagreement among American physicians as to whether the non-maleficence principle excludes the practice of euthanasia.
This argument is disputed in other parts of the world. For example, in the state of Louisiana, giving advice or supplying the means to end a person's life is considered a criminal act and can be charged as a felony.
Informed consent in ethics usually refers to the idea that a person must be fully informed about and understand the potential benefits and risks of their choice of treatment. An uninformed person is at risk of mistakenly making a choice not reflective of his or her values or wishes. It does not specifically mean the process of obtaining consent, or the specific legal requirements, which vary from place to place, for capacity to consent.
Patients can elect to make their own medical decisions or can delegate decision-making authority to another party. Confidentiality is commonly applied to conversations between doctors and patients.
Legal protections prevent physicians from revealing their discussions with patients, even under oath in court. However, numerous exceptions to the rules have been carved out over the years. For example, many states require physicians to report gunshot wounds to the police and impaired drivers to the Department of Motor Vehicles. Confidentiality is also challenged in cases involving the diagnosis of a sexually transmitted disease in a patient who refuses to reveal the diagnosis to a spouse, and in the termination of a pregnancy in an underage patient, without the knowledge of the patient's parents.
The book is divided into 23 chapters. The introductory chapters present some basic concepts of medical ethics, such as the relation between the legal system and ethics, ethical documents, ethical theories, and ethical analysis. The following chapters address issues of importance in all fields of medicine: respecting autonomy, communication, relations within a healthcare team, professional malpractice, limited resources, and the portrait of a physician. The book offers a valuable resource for physicians of all specialties, students of medicine, professionals, and students from other fields devoted to human health, journalists, and general readers with an interest in medicine. He has authored more than 45 papers included in the PubMed database and has co-edited two books: Communication with the cancer patient: information and truth The New York Academy of Sciences, and New challenges in communication with the cancer patient Springer, In addition to his formal achievements and positions, his main qualification is 40 years of personal experience devoted to treating patients with cancer.
PDF | Review of 4th edn: 'Pattinson deftly weaves the ethical and the legal sdstringteachers.orgson has rigorously rewritten his textbook for its.
Scenario: A professional medical writer paid by a pharmaceutical company is working with external authors to develop a review article. The medical writer performs the research required to identify requisite materials for the review article. Balance competing medical ethics in making decisions about patient care 3. Define Decision Making Capacity 4.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy , non-maleficence, beneficence , and justice.
He recalled the man: a scraggy type on a Harley, some biker wannabe. The man had trailed him through Espanola, past Abiquiu and Ghost Ranch, hanging two hundred yards back, making no effort at deception. Still wearing the biker head scarf, he followed him on foot up Joaquin Wash from the ChamaRiver. Weathers had lost his pursuer in the Maze and reached the top of the Mesa of the Ancients before the biker found his way out. Two weeks later, here he was again-a persistent little bastard. And nine months into that war, Maddox lost fourteen men and an ear that horrific afternoon.
Edited by Lawrence O. The editor adopts this holistic perspective out of an appreciation for the limits of viewing public health from a strictly biological-epidemiological viewpoint. The anthology is intended for a broad audience, including scholars, practitioners, and the informed public in the fields of law, public health, medicine, nursing, and public administration. The content was chosen with a primary focus on practice, and can be combined with a companion volume that focuses on theory and methods. The material is timely, with classical readings included for background. Selections include scholarly articles, reports, and court cases, with the author-editor providing original articles and discussions. The editor takes an active role in discussion and analysis, rather than presenting a simple aggregate of relevant work with summary paragraphs.
У нас в шифровалке человек взят в заложники. Быстро пришлите сюда людей. Да, да, прямо. К тому же у нас вышел из строя генератор. Я требую направить сюда всю энергию из внешних источников.
PDF | The subject of interest in this article is the importance of knowing and connecting medical ethics and medical ethics and medical law for the category of health workers. first time in in the book "Bioethics - Bridge.
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Сьюзан испытала от этих слов странное облегчение. - У него есть охрана.
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Он посмотрел на Сьюзан, стоявшую рядом с ним на платформе. Казалось, все происходящее было от нее безумно. Джабба вздохнул и снова вытер пот со лба.
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Lois Ritter - is a consultant in health and education.