Medical Ethics Evolution Rights And The Physician

The subject of medical ethics is always current and offers an inviting theme, particularly for anyone who has spent his life in medical practice. But the subject of ethics is impossible to deal with unless one first asks its purposes. Therefore, this book is divided into two parts, the first comprehends theoretical considerations and the second, pragmatic and empirical data on, and discussions of, current problems. Part One will be of greater interest to moral philosophers, philosophers and historians of science, and social scientists. Part Two should have greater appeal to physicians, medical students and medical planners. Nevertheless, it is hoped that the latter will look into Part One for the justification of the conclusions the author could reach on the material presented in Part Two. Likewise, it will become obvious why it is believed the solutions of many, if not most, ethical dilemmas are not always discernible at a given moment in time. Also, those who are more concerned with the theoretical material of Part One might find its application to current real-life problems interesting. It should not be too much to hope that the entire book will appeal to many general readers. The bio-ethical problems presented are of frequent and growing personal concern, and are discussed almost daily in the news media.

Before Bioethics narrates the history of American medical ethics from its colonial origins to current bioethical controversies over abortion, AIDS, animal rights, and physician-assisted suicide. This comprehensive history tracks the evolution of American medical ethics over four centuries, from colonial midwives and physicians' oaths to medical society codes, through the bioethics revolution. Applying the concept of "morally disruptive technologies," it analyzes the impact of the stethoscope on conceptions of fetal life and the criminalization of abortion, and the impact of the ventilator on our conception of death and the treatment of the dying. The narrative offers tales of those whose lives were affected by the medical ethics of their era: unwed mothers executed by puritans because midwives found them with stillborn babies; the unlikely trio-an Irishman, a Sephardic Jew and in-the-closet gay public health reformer-who drafted the American Medical Association's code of ethics but received no credit for their achievement, and the founder of American gynecology celebrated during his own era but condemned today because he perfected his surgical procedures on un-anesthetized African American slave women. The book concludes by exploring the reasons underlying American society's empowerment of a hodgepodge of ex-theologians, humanist clinicians and researchers, lawyers and philosophers-the bioethicists-as authorities able to address research ethics scandals and the ethical problems generated by morally disruptive technologies. To access the companion website for Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution, please visit: http://global.oup.com/us/companion.websites/9780199774111/

D.--from the Introduction "Canadian Bulletin of Medical History"

Medical ethics changed dramatically in the past 30 years because physicians and humanists actively engaged each other in discussions that sometimes led to confrontation and controversy, but usually have improved the quality of medical decision-making. Before then, medical ethics had been isolated for almost two centuries from the larger philosophical, social, and religious controversies of the time. Only in the past three decades has the dialogue resumed as physicians turned to humanists for help just when humanists wanted their work to be relevant to real-life social problems. The book tells the critical story of how the breakdown in communication between physicians and humanists occurred and how it was repaired when new developments in medicine together with a social revolution forced the leaders of these two fields to resume their dialogue.

David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making. Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man's best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers. The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical pract

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.

The story of two doctors, a father and son, who practiced in very different times and the evolution of the ethics that profoundly influence health care As a practicing physician and longtime member of his hospital’s ethics committee, Dr. Barron Lerner thought he had heard it all. But in the mid-1990s, his father, an infectious diseases physician, told him a stunning story: he had physically placed his body over an end-stage patient who had stopped breathing, preventing his colleagues from performing cardiopulmonary resuscitation, even though CPR was the ethically and legally accepted thing to do. Over the next few years, the senior Dr. Lerner tried to speed the deaths of his seriously ill mother and mother-in-law to spare them further suffering. These stories angered and alarmed the younger Dr. Lerner—an internist, historian of medicine, and bioethicist—who had rejected physician-based paternalism in favor of informed consent and patient autonomy. The Good Doctor is a fascinating and moving account of how Dr. Lerner came to terms with two very different images of his father: a revered clinician, teacher, and researcher who always put his patients first, but also a physician willing to “play God,” opposing the very revolution in patients' rights that his son was studying and teaching to his own medical students. But the elder Dr. Lerner’s journals, which he had kept for decades, showed the son how the father’s outdated paternalism had grown out of a fierce devotion to patient-centered medicine, which was rapidly disappearing. And they raised questions: Are paternalistic doctors just relics, or should their expertise be used to overrule patients and families that make ill-advised choices? Does the growing use of personalized medicine—in which specific interventions may be best for specific patients—change the calculus between autonomy and paternalism? And how can we best use technologies that were invented to save lives but now too often prolong death? In an era of high-technology medicine, spiraling costs, and health-care reform, these questions could not be more relevant. As his father slowly died of Parkinson’s disease, Barron Lerner faced these questions both personally and professionally. He found himself being pulled into his dad’s medical care, even though he had criticized his father for making medical decisions for his relatives. Did playing God—at least in some situations—actually make sense? Did doctors sometimes “know best”? A timely and compelling story of one family’s engagement with medicine over the last half century, The Good Doctor is an important book for those who treat illness—and those who struggle to overcome it.

A collection of readings on topics such as abortion, organ transplantation, and HIV. Valuable for practitioners, and students of medical ethics.

Film and literature have long been mined for interesting examples and case studies in order to teach biomedical ethics to students. This volume presents a collection of about 80 very brief, accessible essays written by international experts from medicine, social sciences, and the humanities, all of whom have experience using film in their teaching of medical ethics. Each essay focuses on a single scene and the ethical issues it raises, and the volume editors have provided strict guidelines for what each essay must do, while also allowing for some creative freedom. While some of the films are obvious candidates with medical themes -- "Million Dollar Baby", "The Diving Bell and the Butterfly" -- some are novel choices, such as "Pan's Labyrinth" or "As Good as it Gets". The book will contain several general introductory chapters to major sections, and a complete filmography and cross-index at the end of the book where readers can look up individual films or ethical issues.

Emanual (oncology and medical ethics, Harvard) rejects the argument that recent issues of medical ethics are the result of new technologies, and contends that they are an inevitable consequence of liberal political values. He proposes a communitarian solution. Annotation copyrighted by Book News, Inc., Portland, OR