Resolving Ethical Dilemmas

by Lo, Bernard, M.D.

• ISBN13: 9780781753579
• ISBN10: 0781753570
• Edition: 3rd
• Format: Paperback
• Copyright: 2005-03-14
• Publisher: LIPPINCOTT WILLIAMS & WILKINS

Summary

Every day clinicians face ethical dilemmas, many of which result from medical advances and challenges in managed care. How practitioners resolve these challenges has a direct impact on patient care. This timely Third Edition will keep you up to date on a wide range of ethical dilemmas and new ways of thinking about them. Highlights of this edition include: / Important new material addressing federal privacy regulations, disclosure of medical errors, limits on residents' working hours, patient compliance with public health directives, genetic testing, gifts from drug companies, and more / Revised sections on decision-making near the end of life / Update on organ transplantation including living donations and financial incentives for donation / Plus more real-life cases to illustrate ethical dilemmas and challenge your critical thinking skills This useful resource is a must-read for medical students and practicing professionals at every level of experience. It presents real patient problems and provides an easy-to-use format to help you develop an action plan that provides the best medical care to your patients.

Table of Contents

SECTION I Fundamentals of Clinical Ethics
An Approach to Ethical Dilemmas in Patient Care	3	(7)
Overview of Ethical Guidelines	10	(7)
Informed Consent	17	(11)
Promoting the Patient's Best Interests	28	(8)
Confidentiality	36	(9)
Avoiding Deception and Nondisclosure	45	(9)
Keeping Promises	54	(5)
SECTION II Shared Decision Making
An Approach to Decisions About Clinical Interventions	59	(2)
Futile Interventions	61	(6)
Decision-making Capacity	67	(8)
Refusal of Treatment by Competent, Informed Patients	75	(4)
Standards for Decisions When Patients Lack Decision-making Capacity	79	(11)
Surrogate Decision Making	90	(5)
Persistent Disagreements over Care	95	(10)
SECTION III Decisions About Life-Sustaining Interventions
Confusing Ethical Distinctions	105	(6)
Ethics Committees and Case Consultations	111	(6)
Do Not Attempt Resuscitation Orders	117	(8)
Tube and Intravenous Feedings	125	(5)
Physician-Assisted Suicide and Active Euthanasia	130	(10)
The Persistent Vegetative State	140	(3)
Determination of Death	143	(4)
Legal Rulings on Life-Sustaining Interventions	147	(8)
SECTION IV The Doctor-Patient Relationship
Overview of the Doctor--Patient Relationship	155	(2)
Refusal to Care for Patients	157	(6)
Gifts from Patients to Physicians	163	(5)
Sexual Contact between Physicians and Patients	168	(6)
Secret Information about Patients	174	(2)
Clinical Research	176	(9)
SECTION V Conflicts of Interest
Overview of Conflicts of Interest	185	(4)
Bedside Rationing of Health Care	189	(7)
Incentives for Physicians to Increase Services	196	(4)
Incentives for Physicians to Decrease Services	200	(9)
Gifts from Drug Companies	209	(4)
Disclosing Errors	213	(8)
Impaired Colleagues	221	(5)
Ethical Dilemmas Students and House Staff Face	226	(9)
SECTION VI Ethical Issues in Clinical Specialities
Ethical Issues in Pediatrics	235	(8)
Ethical Issues in Surgery	243	(6)
Ethical Issues in Obstetrics and Gynecology	249	(7)
Ethical Issues in Psychiatry	256	(8)
Ethical Issues in Organ Transplantation	264	(8)
Testing for Genetic Conditions	272	(8)
Ethical Issues in Public Health Emergencies	280	(5)
Cases for Discussion	285	(11)
Index	296