Discussions of over 200 selected ethical problems that face the practicing physician on a daily basis. Alphabetical arrangement of problems, ranging from abortion to Zen. Entry includes lengthy discussion and references.

Healthcare facilities in receiving countries regularly encounter guest workers whose need for acute or subacute care triggers the prospect of termination of employment and repatriation. In these scenarios, country‐specific migration and employment policies and norms of medical professionalism and ethics offer some guidance, but also create tensions. It is not clear under what conditions such medical repatriation is ethically permissible.This paper analyses the application of a previously articulated criteria for the ethical medical repatriation of undocumented immigrants, to (...) the situation of documented guest workers, with focus on the context of Singapore. We examine how these standards could be adapted and applied to the provision of care for guest workers, and argue that healthcare institutions and medical professionals have a duty to intervene in employers’ decisions to repatriate guest workers for medico‐economic reasons when repatriation essentially amounts to ‘patient dumping’. Barriers and challenges in implementing the criteria, and their possible solutions will be discussed. (shrink)

Ethical medical decision-making for a child is generally navigated with various standards and models that have been developed to address its complexities. A case is presented of the parents’ refusal of a surgical procedure for their child considered by medical providers as essential and potentially lifesaving, along with the ethical debate of whether the parents’ decision was in the child’s best interest and whether their refusal reached a threshold to report and seek state intervention. Utilizing the best interest (...) standard and additional ethical decision-making tools, the ethicists helped the medical team accept the parents’ decision as reasonable, thus avoiding involvement with Child Protective Services. It is my goal to clarify the parents’ decision as reasonable and as honoring their child’s best interests and inherent dignity through the lens of Catholic anthropological and moral principles. These strengthen the ethical and moral arguments for the parents’ decision and the opposition to state intervention. (shrink)

The Council on Ethical and Judicial Affairs of the American Medical Association examines physicians’ professional ethical responsibility in the event that the security of patients’ electronic records is breached.

Volume 25, Issue 2, February 2025, Page 1-2.

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

In this book, Ramsey addresses the moral problems of medicine, life and death and not merely to those who share his faith.

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

BackgroundThe methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts.DiscussionA considered reference to normative research questions can be expected from good quality empirical research in (...) class='Hi'>medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics.SummaryHigh quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. (shrink)

Large language models (LLMs) have now entered the realm of medical ethics. In a recent study, Balaset alexamined the performance of GPT-4, a commercially available LLM, assessing its performance in generating responses to diverse medical ethics cases. Their findings reveal that GPT-4 demonstrates an ability to identify and articulate complex medical ethical issues, although its proficiency in encoding the depth of real-world ethical dilemmas remains an avenue for improvement. Investigating the integration of LLMs into medical ethics (...) decision-making appears to be an interesting avenue of research. However, despite the promising trajectory of LLM technology in medicine, it is crucial to exercise caution and refrain from attributing their expertise to medical ethics. Our thesis follows an examination of the nature of expertise and the epistemic limitations that affect LLM technology. As a result, we propose two more fitting applications of LLMs in medical ethics: first, as tools for mining electronic health records or scientific literature, thereby supplementing evidence for resolving medical ethics cases, and second, as educational platforms to foster ethical reflection and critical thinking skills among students and residents. The integration of LLMs in medical ethics, while promising, requires careful consideration of their epistemic limitations. Consequently, a well-considered definition of their role in ethically sensitive decision-making is crucial. (shrink)

Volume 20, Issue 8, August 2020, Page 117-118.

This is the first book to provide a coherent overview over the ethical implications of AI-related technologies in medicine. It explores how these technologies transform practices, relationships, and environments in the clinical field. It provides an introduction into ethical issues such as data security and privacy protection, bias and algorithmic fairness, trust and transparency, challenges to the doctor-patient relationship, and new perspectives for informed consent. The book focuses on the transformative impact that technology is having on medicine, and discusses several (...) strategies for dealing with the resulting challenges. It also introduces innovative methods of ethics research for addressing existing desiderata and future challenges. This book is written to inform health care professionals, policy-makers, and researchers in medicine, health sciences, nursing science, social sciences, and ethics, but may also function as a primary textbook for graduate as well as undergraduate university courses. (shrink)

The use of terminal sedation to control theintense discomfort of dying patients appearsboth to be an established practice inpalliative care and to run counter to the moraland legal norm that forbids health careprofessionals from intentionally killingpatients. This raises the worry that therequirements of established palliative care areincompatible with moral and legal opposition toeuthanasia. This paper explains how thedoctrine of double effect can be relied on todistinguish terminal sedation from euthanasia. The doctrine of double effect is rooted inCatholic moral casuistry, but (...) its applicationin law and morality need not depend on theparticular framework in which it was developed. The paper further explains how the moral weightof the distinction between intended harms andmerely foreseen harms in the doctrine of doubleeffect can be justified by appeal to alimitation on the human capacity to pursue good. (shrink)

A discussion of Christian ethics focuses on the physician's image as a parent, warrior against death, expert, and teacher, and the oath that guides his or her practice.

The notion of autonomy commonly employed in medical ethics literature and practices is inadequate on three fronts: it fails to properly identify nonautonomous actions and choices, it gives a false account of which features of actions and choices makes them autonomous or nonautonomous, and it provides no grounds for the moral requirement to respect autonomy. In this paper I offer a more adequate framework for how to think about autonomy, but this framework does not lend itself to the kinds (...) of practical application assumed in medical ethics. A general problem then arises: the notion of autonomy used in medical ethics is conceptually inadequate, but conceptually adequate notions of autonomy do not have the practical applications that are the central concern of medical ethics. Thus, a revision both of the view of autonomy and the practice of “respect for autonomy” are in order. (shrink)

Titel oversat: Islamisk, medicinsk etik i det tyvende århundrede.

The British Government is implementing some major alterations to the way health services in Great Britain are organised. As well as the introduction of competition between health care providers, their financial interests are to be linked to their output, in efforts to use market forces to increase efficiency and cut costs. This paper looks at the possible impact of these changes of health care organisation on ethical medical practice. This is investigated with particular reference to the country whose health (...) service has embraced most closely these elements of the market--the United States of America. The question to be answered is whether high standards of ethical care are ensured by factors somehow intrinsic to the medical profession, and are therefore immune to changes in the economics of health care. This assumption is shown to be questionable in light of what is known about the determinants of ethical medical practice. (shrink)

This book examines the moral luck paradox, relating it to Kantian, consequentialist and virtue-based approaches to ethics. It also applies the paradox to areas in medical ethics, including allocation of scarce medical resources, informed consent to treatment, withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing and medical research. If risk and luck are taken seriously, it might seem to follow that we cannot develop any definite moral standards, that we are doomed to moral relativism. However, Dickenson offers (...) strong counter-arguments to this view that enable us to think in terms of universal standards. (shrink)

The fields of medical ethics, bioethics, and women's studies have experienced unprecedented growth in the last forty years. Along with the rapid pace of development in medicine and biology, and changes in social expectations, moral quandaries about the body and social practices involving it have multiplied. Philosophers are uniquely situated to attempt to clarify and resolves these questions. Yet the subdiscipline of bioethics still in large part reflects mainstream scholars' lack of interest in gender as a category of analysis. (...) This volume aims to show how a feminist perspective advances bioethics. The author uncover inconsistencies in traditional arguments and argue for the importance of hitherto ignored factors in decision-making. The essays include theory and very specific examples that demonstrate the glaring inadequacy of mainstream bioethics, where gender bias is still often to be found, along with general lack of attention to women's concerns. (shrink)

Empathy is a thing constantly asked for and stressed as a central skill and character trait of the good physician and nurse. To be a good doctor or a good nurse one needs to be empathic—one needs to be able to feel and understand the needs and wishes of patients in order to help them in the best possible way, in a medical, as well as in an ethical sense. The problem with most studies of empathy in medicine is (...) that empathy is poorly defined and tends to overlap with other related things, such as emotional contagion, sympathy, or a caring personality in general. It is far from clear how empathy fits into the general picture of medical ethics and the framework of norms that are most often stressed there, such as respect for autonomy and beneficience. How are we to look upon the role and importance of empathy in medical ethics? Is empathy an affective and/or cognitive phenomenon only, or does it carry moral significance in itself as a skill and/or virtue? How does empathy attain moral importance for medicine? In this paper I will attempt to show that a comparison with the Aristotelian concept of phronesis makes it easier to see what empathy is and how it fits into the general picture of medical ethics. I will argue that empathy is a basic condition and source of moral knowledge by being the feeling component of phronesis, and, by the same power, it is also a motivation for acting in a good way. (shrink)

This syllabus was submitted to the Rhodes College Office of Academic Affairs by the course instructor.

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

Given the profound influence of social media and emerging evidence of its effects on human behavior and health, bioethicists have an important role to play in the development of professional standards of conduct for health professionals using social media and in the design of online systems themselves. In short, social media is a bioethics issue that has serious implications for medical practice, research, and public health. Here, we inventory several ethical issues across four areas at the intersection of social (...) media and health: the impact of social networking sites on the doctor‐patient relationship, the development of e‐health platforms to deliver care, the use of online data and algorithms to inform health research, and the broader public health consequences of widespread social media use. In doing so, we review discussions of these topics and emphasize the need for bioethics to focus more deeply on the ways online technology platforms are designed and implemented. We argue that bioethicists should turn their attention to the ways in which consumer engagement, bias, and profit maximization shape online content and, consequently, human behavior and health. We also offer a set of recommendations and suggest future directions for addressing ethical challenges in these domains. (shrink)

In 2014, the editorial board of BMC Medical Ethics came together to devise sections for the journal that would give structure to the journal help ensure that authors’ research is matched to the most appropriate editors and help readers to find the research most relevant to them. The editorial board decided to take a practical approach to devising sections that dealt with the challenges of content management. After that, we started thinking more theoretically about how one could go about (...) classifying the field of medical ethics. This editorial elaborates and reflects on the practical approach that we took at the journal, then considers an alternative theoretically derived approach, and reflects on the possibilities, challenges and value of classifying the field more broadly. (shrink)

This paper considers the relation between medical ethics (ME) and common morality (CM), professional norms, and moral philosophy. It proceeds by analyzing two recent book-length critical analyses of this relationship by Bob Baker in “The Structure of Moral Revolutions—Studies of Changes in the Morality of Abortion, Death, and the Bioethics Revolution” and Rosamond Rhodes in “The Trusted Doctor—Medical Ethics and Professionalism.” It argues that despite the strengths of these critical arguments, there is nevertheless a relationship between ME, understood (...) as the professional ethics of the healthcare professions, and both CM and moral philosophy. It also argues that ME cannot and should not be understood purely as the internally developed professional norms of the medical or healthcare professions. (shrink)

I will argue that there are difficulties with the application of the four principles approach to incompetent children. The most important principle – respect for autonomy – is not directly applicable to incompetent children and the most appropriate modification of the principle for them is not clear. The principle of beneficence – that one should act in the child’s interests – is complicated by difficulties in assessing what a child’s interests are and to which standard of interests those choosing for (...) children should be held. A further problem with the four principles approach is that parental authority does not follow clearly from the four principles. (shrink)

Introduction: Pharmaceutical companies offer various gifts to physicians to encourage them to prescribe their products. This collaboration has some negative and positive aspects. Different countries have established guidelines to limit the collaboration and reform such relationships. This study aims to determine the attitude of Bangladeshi medical students towards pharmaceutical gifts, physician-pharmacist collaboration, and associated factors. Methods: An online cross-sectional and correlational study was conducted through email and Google-Forms among Bangladeshi medical students. A total of 435 students from different (...) medical colleges completed the questionnaires in May and June, 2016. Results: Monthly parental income was moderate among the majority of medical students. Less than 16% had a physician or pharmacist parent. Most of the students were taught about medical ethics, but 73% were not taught about the ethics of physician-pharmacist collaboration. About 85% did not have any experience of interaction with marketing representatives. Drug samples and pennotepads were the most appreciated pharmaceutical gifts. Jewelry and gifts costing more than 100 thousand were said to be the least appreciated pharmaceutical gifts. Attitudes towards drug companies and representatives were assessed by fifteen statements. Medical students had a variety of attitudes regarding its ethical justification. Attitudes were correlated with gender, parental income, physician parents, academic years, and having been taught about pharmaceutical collaboration with physicians. Conclusion and Recommendations: medical students should elaborate on ethical reasoning before accepting pharmaceutical gifts. Medical colleges and curriculums should teach them about the interaction. A national guideline may be needed. (shrink)

This issue of The Journal of Medicine and Philosophy is unified by a theme of what contributes to and detracts from patient well-being. I highlight this unifying thread through five of this issue’s contributions, dividing them according to whether they are predominantly about what diminishes or enhances the well-being of patients. Three of them are more directly relevant to whether certain actions diminish well-being, and two of them touch more closely on what promotes well-being. Although these papers are generally focused (...) on what is good or detrimental for patients, their insights are also relevant to the nature of human flourishing. (shrink)

This rich collection, popular among teachers and students alike, provides an in-depth look at major cases that have shaped the field of medical ethics. The book presents each famous (or infamous) case using extensive historical and contextual background, and then proceeds to illuminate it by careful discussion of pertinent philosophical theories and legal and ethical issues.

The Socratic method has a long history in teaching philosophy and mathematics, marked by such names as Karl Weierstra, Leonard Nelson and Gustav Heckmann. Its basic idea is to encourage the participants of a learning group (of pupils, students, or practitioners) to work on a conceptual, ethical or psychological problem by their own collective intellectual effort, without a textual basis and without substantial help from the teacher whose part it is mainly to enforce the rigid procedural rules designed to ensure (...) a fruitful, diversified, open and consensus-oriented thought process. Several features of the Socratic procedure, especially in the canonical form given to it by Heckmann, are highly attractive for the teaching of medical ethics in small groups: the strategy of starting from relevant singular individual experiences, interpreting and cautiously generalizing them in a process of inter-subjective confrontation and confirmation, the duty of non-directivity on the part of the teacher in regard to the contents of the discussion, the necessity, on the part of the participants, to make explicit both their own thinking and the way they understand the thought of others, the strict separation of content level and meta level discussion and, not least, the wise use made of the emotional and motivational resources developing in the group process. Experience shows, however, that the canonical form of the Socratic group suffers from a number of drawbacks which may be overcome by loosening the rigidity of some of the rules. These concern mainly the injunction against substantial interventions on the part of the teacher and the insistence on consensus formation rooted in Leonard Nelson's Neo-Kantian Apriorism. (shrink)

Medical ethics educators have a responsibility to assess the dominant ped­agogical methods and textbooks we utilize to advance our students’ knowledge about cultural differences and health disparities. In this essay, I argue that intersectional theory functions as an effective tool for the assessment and correction of diversity, equity, and inclusion training models for medical students. I critique, in particular, the additive conceptions of identity and diversity that dominate the literature. Intersectional theorists also provide helpful directives for how to (...) train students to be suspicious of social categories and their relations to power structures. Their ideas can be used to create parameters for case-based learning so as not to undertheorize the culture of medicine and to add depth to core concepts like autonomy and privacy through much-needed investigations of identity formation and expression. Ultimately, intersectional theory pushes medical ethicists to educate their students to understand difference, diversity, and inequity within a wider moral frame. (shrink)

A purely deductive medical ethics cannot properly account for the varieties of circumstances which arise in medical practice. By contrast, a purely inductive medical ethics lacks sufficient guidance from ethical principles. In resolving ethical dilemmas in medicine, most often an appeal is made to middle-level axioms and methodological rules to mediate between theory and practice. I argue that this appeal must be augmented by considerations of context, such considerations, in effect, constituting a moral rule based on the (...) social structure of medical practice. A contextual grid is proposed which assists the process of weighing values in resolving cases. (shrink)

The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain (...) this absence. I draw on the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of ‘relational ontology’ originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients. (shrink)

(2001). The Challenge of Genetic Engineering to Medical Anthropology and Ethics. Human Reproduction & Genetic Ethics: Vol. 7, No. 1, pp. 21-25.