Medical Ethics in Clinical Practice

von: Matjaž Zwitter

Springer-Verlag, 2019

ISBN: 9783030007195

Sprache: Englisch

216 Seiten, Download: 5235 KB

Format: PDF, auch als Online-Lesen

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Medical Ethics in Clinical Practice

	Preface	5
	Contents	7
	1: Ethics and Law	14
	1.1 Law	15
	1.2 Ethics	15
	1.3 Law and Ethics: Why Do We Need Two Systems?	16
	Suggested Reading	17
	2: Ethical Codes and Declarations	19
	2.1 Hippocratic Oath and Other Ancient Documents	20
	2.2 Medical Ethics in Modern Documents	22
	2.3 Advantages and Disadvantages of Normative Ethics	23
	References	23
	Suggested Reading	23
	Selected Codes of Medical Ethics	24
	3: Ethical Theories	26
	3.1 Utilitarian Ethics	28
	3.2 Deontological Ethics	29
	3.3 Virtue Ethics	30
	3.4 The Four Principles and Common Morality Ethics	31
	Reference	33
	Suggested Reading	33
	4: Moral Status	34
	4.1 Who Has Moral Status?	35
	4.2 Criteria for Moral Status	36
	Reference	38
	Suggested Reading	38
	5: Ethical Analysis	39
	Suggested Reading	44
	6: Autonomy and Its Limitations	45
	6.1 Right to Information	47
	6.2 Right to Confidence	47
	6.3 Right to Privacy	49
	6.4 Voluntary Surrender of Autonomy	50
	6.5 Patients’ Autonomy and Cultural Diversity	50
	6.6 Persons with Limited Autonomy	50
	6.7 Surrogate Decision-Makers	51
	6.8 Advanced Directives	52
	6.9 Physician’s Autonomy and Conscientious Objection	53
	Suggested Reading	53
	7: Communication	55
	7.1 Information Flows in Multiple Directions	56
	7.2 Communication as a Process	57
	7.3 Modern Media and the Internet	57
	7.4 The Broad Scope of the Conversation	58
	7.5 The Opaqueness of the Medical Jargon	59
	7.6 Cultural Diversity	60
	7.7 Practical Advice	60
	Suggested Reading	61
	8: Relations in the Medical Team	63
	8.1 Professional Competence	64
	8.2 Communication in a Medical Team	64
	8.3 Disagreement and Conflicts	65
	8.4 Positive Team Spirit	66
	Suggested Reading	66
	9: Professional Malpractice	67
	9.1 Mistake, Error, Neglect, Unfortunate Coincidence?	68
	9.1.1 Limited Resources, Compromises in Probability-Based Medicine, and the Right to Compensation	69
	9.2 Criminalization of Professional Malpractice	70
	9.3 The Media, the Public, and Professional Mistakes	70
	9.4 Support for the Accused Physician	71
	Reference	71
	Suggested Reading	71
	10: Limited Resources, Priorities, and Corruption	73
	10.1 Consequences of Poorly Organized Healthcare	74
	10.2 Probability-Based Medicine	76
	10.3 Priorities	77
	10.4 Corruption	79
	Reference	80
	Suggested Reading	80
	11: Image of a Physician	82
	11.1 The Physician in Exceptional Circumstances	84
	11.2 Who Is a Good Physician?	85
	11.3 Who Is Draining the Idealism from Our Profession?	86
	11.4 Burnout and the Anchor Outside Medicine	86
	11.5 Conscientious Objection and the Respect of Personal Values	87
	11.6 Digressions	88
	Reference	89
	Suggested Reading	89
	12: Preventive Medicine	90
	12.1 Vaccination	91
	12.2 Healthy Lifestyle	92
	12.3 Protection of Vulnerable Groups of Society	93
	12.4 Epidemiology and Epidemiological Studies	93
	12.5 Return to the Introductory Parable	93
	Suggested Reading	94
	13: Ethics at the Beginning of Life	95
	13.1 Natural Conception	96
	13.1.1 Contraception	96
	13.1.2 Morning-After Pill	96
	13.1.3 Abortion	96
	13.1.4 Prenatal Diagnostics	97
	13.1.5 Delivery at Home	98
	13.2 Sterilization	98
	13.3 Insemination or Egg Cell Donation	98
	13.4 Medically Assisted Insemination for Healthy Women	99
	13.5 In Vitro Fertilization	100
	13.6 Surrogate Motherhood	101
	References	102
	Suggested Reading	102
	14: Pediatrics	104
	14.1 The Newborn	105
	14.2 Vaccination	106
	14.3 Child Neglect and Maltreatment	108
	14.4 Chronic Disease and Communication	109
	14.5 Genetics	109
	14.6 Death of a Child	110
	14.7 Research	110
	References	111
	Suggested Reading	111
	15: Genetics	112
	15.1 What Information Can Be Gained from Genetic Testing?	113
	15.2 Disease Exclusion, Choice of Gender, and Selection of Other Traits of the Future Child	114
	15.3 Genetic Testing in Childhood and Adulthood	116
	15.4 Accidental Findings	117
	Suggested Reading	118
	16: Emergency Medicine and Transplantation	120
	16.1 Admission to the Intensive Care Unit	122
	16.2 Introducing, Withholding, and Withdrawing Intensive Care	122
	16.3 Futile Intensive Care	123
	16.4 Determining Death	123
	16.5 Organ Transplantation	124
	Reference	125
	Suggested Reading	125
	17: The Elderly and the Mentally-Ill	126
	17.1 Who Are the Elderly?	128
	17.2 Who Are the Mentally Ill?	129
	17.3 Impaired Critical Judgement and Loss of Autonomy	130
	17.4 Surrogate Decision-Making	130
	17.5 Acting Against the Will of the Patient	131
	17.6 Hunger Striking and Anorexia Nervosa	131
	17.7 Social Status and Stigmatization	132
	Suggested Reading	132
	18: Dying and Death	134
	18.1 The Wish to Die and Suicide	136
	18.2 What Is Not Euthanasia?	137
	18.3 Euthanasia and Physician-Assisted Suicide	137
	18.4 Persistent Vegetative State	139
	18.5 On Immortality	140
	18.6 Education and Research	141
	References	141
	Suggested Reading	141
	19: Research	143
	19.1 The Four Phases of Clinical Trials	145
	19.2 Patient Information	147
	19.3 Academic Clinical Trials	148
	19.4 Clinical Trials with a Commercial Sponsor	149
	19.5 Progress, Patient Solidarity, and Honesty	152
	References	153
	Suggested Reading	154
	20: Unproven Methods of Diagnostics and Treatment	156
	20.1 Alternative Diagnostics	158
	20.2 Supplementary and Alternative Treatment	159
	20.3 Right to Try	159
	References	161
	Suggested Reading	161
	21: Physicians Beyond Patient Care	162
	21.1 Managerial Responsibilities and Politics	163
	21.2 Expert	164
	21.3 The Physician, the Pharmaceutical Industry, and Medical Equipment Providers	164
	21.4 Teacher	165
	21.5 The Physician in Public	166
	21.6 Sports Medicine	166
	21.7 Physician as Patient	167
	References	168
	Further Reading	168
	22: Student Seminars	170
	22.1 Surrogate Motherhood	173
	22.2 Physician’s Confidentiality	174
	22.3 Eluana Englaro	174
	22.4 Love Life	175
	22.5 Donor for Bone Marrow Transplantation	175
	22.6 Unsolicited Medical Intervention	176
	22.7 Elderly Driver	176
	22.8 Posthumous Insemination	177
	22.9 Physician as Patient	177
	22.10 Crime Due to Mental Disease	178
	22.11 Conscientious Objection	178
	22.12 Ethics and Gladiators in Professional Sports	179
	22.13 Medical Malpractice and the Right to Compensation	179
	22.14 Anorexia Nervosa	180
	22.15 Prevention of Pregnancy in Psychiatric Patient	180
	22.16 Placebos in Clinical Trials	181
	22.17 Choosing the Gender of the Newborn	181
	22.18 Vegan Diet for Children	182
	22.19 Accusation of Medical Malpractice: Disclosure of Personal Information	182
	22.20 Boxing	183
	22.21 Gifts	183
	22.22 Drug Addicts, Pregnancy, and Parenthood	184
	22.23 Who Is a Good Physician?	184
	22.24 Parents Declining Mandatory Vaccination of Their Children	184
	22.25 Collaboration Between the Psychiatrist and the Family Physician	185
	22.26 Medically Assisted Insemination for Healthy Women	185
	22.27 Physicians as Leading Politicians	186
	22.28 Shooting as an Olympic Sport	186
	22.29 Fine-Needle Biopsy of the Breast for a 12-Year-Old Girl	187
	22.30 The Death of Ivan Ilyich	187
	22.31 Waiting Periods for Funerals	187
	22.32 Cancer Ward	188
	22.33 Physician-Alcoholic	188
	22.34 Disappearance of Inexpensive Drugs with Long-Lasting Positive Experience	188
	22.35 Empathy and Trust	189
	22.36 Medical Treatment of Patients Without Health Insurance	189
	22.37 Doping in Sports	190
	22.38 Intimate Relationships with a Patient	190
	22.39 Paulo Coelho: Veronica Decides to Die	191
	22.40 Communication with a Troublesome Patient	191
	22.41 The Franja Partisan Hospital	192
	22.42 Donor of Embryonic Stem Cells and Anonymity	192
	22.43 Addiction to Prescription Drugs	193
	22.44 Literature as a Medication	194
	22.45 Sinclair Lewis: “Arrowsmith”	194
	22.46 Female Genital Mutilation	194
	22.47 Accusation of Medical Malpractice	195
	22.48 Transport of a Dying Chronic Patient to the Emergency Department	196
	22.49 Dr. Catherine Hamlin	196
	22.50 An Aggressive Patient	197
	22.51 Legalization of Marihuana	197
	22.52 Lay People’s Attitudes Towards Euthanasia	197
	22.53 Discrimination	198
	22.54 Is Pedophilia a Disease?	199
	22.55 The Nuremberg Trial Against Nazi Physicians	199
	22.56 Humor in Communication with Patients	199
	22.57 Obamacare—American Healthcare Reform: Successes and Difficulties	200
	22.58 Child Abuse	200
	22.59 Ethical Questions in Self-Inflicted Diseases	201
	22.60 Homeopathy	202
	22.61 Treatment of the Demented Patient	202
	22.62 The Physician in Commercials	203
	22.63 The Ebola Epidemic: Ethical Questions	203
	22.64 Gene Testing in Underage Daughters	204
	22.65 Revocation of Driver’s License	204
	22.66 Airplane Seats for Overweight Persons	205
	22.67 Individual Consent for Review of Old Biopsies	205
	22.68 Love in a Nursing Home	206
	22.69 Professional Sports in Children	206
	22.70 Medical Strike	207
	22.71 Artificial Womb	207
	22.72 Genetic Testing for Prediction of a Disease	207
	22.73 Cancerphobia	208
	22.74 Communication in the Waiting Room	209
	22.75 Traditional Medicine	209
	22.76 Late Termination of Pregnancy	209
	22.77 Postponement of Prison Sentence Service for Health Reasons	210
	22.78 Animals in Biomedical Research	210
	22.79 Death of Grandparents	210
	22.80 Guerilla Surgeon	211
	22.81 Loneliness	211
	22.82 Mental Health of Political Leaders	212
	22.83 Eugenics	212
	22.84 Fatherhood	212
	22.85 Mark Langervijk	213
	22.86 Molière and the Characters of Physicians	213
	22.87 Alternative Diagnostics	213
	22.88 Trade with Human Organs for Transplantation	214
	22.89 Dr. Thomas Percival: Medical Ethics	215
	22.90 Mielke and Mitscherlich: “Doctors of Infamy—The Story of the Nazi Medical Crimes”	215
	22.91 Oregon: The Death with Dignity Act	216

Medical Ethics in Clinical Practice

von: Matjaž Zwitter

Medical Ethics in Clinical Practice

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