Description

Within the biomedical field — which encompasses educational institutions, treatment and research centres, and private practice — the pace of technological change in the past few years has been astonishing. Medical education has generally kept pace with these technical changes, but the same cannot be said for medical education pertaining to the many ethical issues raised by these changes. This book is an introduction to biomedical ethics for readers in various fields of medicine and health care.

The first part introduces important concepts in ethical philosophy and then identifies a number of medical principles and concepts of medical practice. The authors go on to outline a model of ethical reasoning that can be used when trying to grapple with the many complex issues faced daily by health-care practitioners.

An emphasis is placed on the need to enunciate an ethical maxim that can be used as the yardstick against which the behavior in question is measured. The final section of the book consists of case studies from diverse areas of the biomedical field. The basic facts of the case are given, and the student is encouraged to engage in moral discourse based on the theoretical models developed in the first part of the book.

Table of Contents

1. Introduction

• New Approaches to Medical Education
• Parallel Approaches to the Ethical Component
• A Brief Overview of Content and Approach Used
• Advice on How to Use This Book

2. It's a Different World

• Medical Practice, Research, and Ethics
• Technological Innovations, New Conceptualizations and Ethics
• The Need for Education in Ethics

3. Introduction to Ethics

• Axiological Framework
• Basic Concepts and Definitions
• Three Ethical Bases
• Ethical Bases (Theories) and Values Clarification
• Moral Discourse and Moral Reasoning
• Agent Accountability
• Model I
• Basic Approach
• Biomedical Moral Discourse

4. Sources of Ethical Decision Making

• Consequentialism (Teleology): What Is Good Behavior?
• Non-Consequentialism (Deontology): What Is Right Behavior?
• Existentialism: What Is Authentic Behavior?
• Synthesis: Good, Right, and Authentic Behavior

5. Moderators Influencing Ethical Decision Making

• Model II
• A Comprehensive Approach

6. The Process of Ethical Decision Making

• The Seven Stages

7. Biomedical Ethical Principles

• Five Biomedical Ethical Principles
• Models of Medical Practice

8. Putting Theory into Action

• A Trial Run with Model
• A Trial Run with Model II

Case Studies

• The Right to Live Longer
• Who, Really, Has the Final Say?
• Anencephalic Babies as Organ Donors
• Alternative Therapy
• Placebos
• Experimental Procedure
• Penalizing a Physician
• Physicians, Pharmaceutical Companies and Gifts
• Physician as Finder for a Fee
• The Right to Die
• Helping to Alleviate Suffering before Death
• Rent-a-Womb
• Abort One Twin
• Abort Some
• Many Fetuses
• Demand for Continuing Futile Therapy
• Full Disclosure: Whose Responsibility?
• Physician, Please Remain Silent (I)
• Physician, Please Remain Silent (II)
• Surrogate Motherhood: Where Is the Boundary?
• Faith and Healing?
• Cost-Benefit Ratio and Health Care
• Who Has the Final Right to Decide?
• Profits Versus Patient Care
• Life or Death for a Baby
• Consulting as Conflict of Interest
• Should There Be a Limit?
• Patient's Rights Versus Physician's Decisions
• Public Good or Corporate Profit?
• Humanitarian Intervention or Opportunity Missed?
• Whose Needs Come First?
• Royalties Versus the Public Good
• Palliation, Quality of Life, Costs Involved
• Cultural Relativism and Western Medical Practice
• Professional Courtesy, Professional Impropriety, and Authenticity
• Profitable Medicine
• Medically Expensive Religious Belief