Resolving Ethical Dilemmas: A Guide for CliniciansDesigned for clinicians, this guide to approaching ethical decisions and developing action plans addresses such routine problems as informed consent and more difficult issues such as economic incentives to decrease medical care. It presents real-life case studies and expands on them to clarify the ethical issues and develop action plans. This edition includes new chapters on paediatrics, surgery, obstetrics and gynaecology, and organizational policies to decrease medical services. |
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Contents
An Approach to Ethical Dilemmas in Patient Care | 3 |
Overview of Ethical Guidelines | 11 |
Informed Consent | 19 |
Responding to Patients Refusals of Beneficial Interventions | 30 |
Confidentiality | 42 |
Avoiding Deception and Nondisclosure | 52 |
Keeping Promises 7 | 62 |
Shared DecisionMaking | 67 |
The DoctorPatient Relationship 25 Overview of the DoctorPatient Relationship | 195 |
Refusal to Care for Patients | 197 |
Gifts from Patients to Physicians | 206 |
Sexual Contact Between Physicians and Patients | 217 |
Secret Information about Patients | 219 |
Clinical Research 206 212 219 | 221 |
Conflicts of Interest | 231 |
Bedside Rationing of Health Care | 236 |
An Approach to Decisions About Clinical Interventions | 69 |
Futile Interventions | 72 |
DecisionMaking Capacity | 80 |
Refusal of Treatment by Competent Informed Patients | 89 |
Standards for Decisions When Patients Lack DecisionMaking Capacity | 94 |
Surrogate DecisionMaking | 111 |
Decisions About LifeSustaining Interventions | 119 |
Confusing Ethical Distinctions | 121 |
Patient or Surrogate Insistence on LifeSustaining Interventions | 128 |
Physician Insistence on LifeSustaining Interventions | 135 |
Ethics Committees and Case Consultations | 140 |
Do Not Resuscitate Orders | 147 |
PhysicianAssisted Suicide and Active Euthanasia | 156 |
Tube and Intravenous Feedings | 167 |
The Persistent Vegetative State | 173 |
Determination of Death | 177 |
Legal Rulings on LifeSustaining Interventions | 181 |
Myths About the Law on LifeSustaining Interventions | 189 |
Incentives for Physicians to Increase Services | 244 |
Incentives for Physicians to Decrease Services | 248 |
Gifts from Drug Companies | 258 |
Disclosing Mistakes | 263 |
Impaired Colleagues | 272 |
Ethical Dilemmas Facing Students and House Staff 231 236 244 248 258 263 271 | 277 |
Ethical Issues in Clinical Specialties | 283 |
Ethical Issues in Pediatrics | 285 |
Ethical Issues in Surgery | 294 |
Ethical Issues in Obstetrics and Gynecology | 309 |
Ethical Issues in Psychiatry 285 294 302 | 310 |
Current Controversies | 319 |
Transmission of HIV Infection in Health Care Settings | 321 |
Ethical Issues in Organ Transplantation | 328 |
Testing for Genetic Conditions 321 328 | 337 |
Cases for Discussion | 345 |
Subject Index | 349 |
Copyright | |