A Casebook of Medical Ethics

by Ackerman, Terrence F.; Strong, Carson

• ISBN13: 9780195039177
• ISBN10: 0195039173
• Edition: 1st
• Format: Paperback
• Copyright: 1989-08-31
• Publisher: Oxford University Press

Summary

Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's religious beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issue involved in clinical medical ethics. Since the analysis of cases plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of Medical Ethics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions.

Author Biography

Terrence F. Ackerman, Ph.D., is Professor and Chairman, Department of Human Values and Ethics, College of Medicine, University of Tennessee, Memphis. He is co-editor of Clinical Medical Ethics: Exploration and Assessment (University Press of America, 1987). Carson Strong, Ph.D., is Associate Professor in the Department of Human Values and Ethics, College of Medicine, University of Tennessee, Memphis.

Table of Contents

Paternalism in the Therapeutic Relationship

Ambivalence Toward Electroconvulsive Therapy

Treatment Refusal in the Medical Intensive Care Unit

An Uncooperative Leukemia Patient

Rehabilitation of a Dependent Patient

Alternative Approaches to Informed Consent

Previous Refusal of Treatment by a Presently Comatose Patient

A Family's Refusal of Blood Transfusions for a Mother and Her Son

Deciding Whether to Discharge a Suicidal Patient

A Request for Sex-Reassigning Surgery

Divulging Information Concerning an Infant's Condition

Duties to Patient and Family

A Daughter's Insistence on Aggressive Treatment

Parental Refusal of Cancer Treatment on Religious Grounds

Informed Consent and the Dying Adolescent

Treatment Refusal for an Infant with Possible Brain Damage

Venereal Disease and Adolescent Confidentiality

Contraceptives for an Adolescent

Request for Abortion for a Retarded Daughter

Request for Hysterectomy for a Retarded Eleven-Year-Old

Conflict About Maintaining a Brain-Dead Woman for the Sake of Her Fetus

Choosing the Method of Delivery for a Fetus with Hydrocephalus

Deciding for Others

A Bedridden and Cognitively Impaired Elderly Patient

Who Should Decide for a Patient in Persistent Vegetative State?

Nasogastric Tube Feedings for an Elderly Stroke Patient

A Prolonged Stay in the Neonatal ICU

Deciding Treatment When the Preliminary Diagnosis is Trisomy 18

Risk/Benefit Assessment of Surgery for a Child Suffering from Strokes

Responding to a Family's Decision for Laetrile

Selecting Therapy for a Mentally Retarded Teenager

Birth Control for a Retarded Woman

A Family's Lack of Commitment

Medical Research Involving Human Subjects

Limited Consent in Alcoholism Research

Disclosure of Preliminary Results in a Randomized Clinical Trial

Constraints on Consent in a Phase I Clinical Trial

Proxy Consent for Incompetent Trauma Patients

Undue Inducement in the Recruitment of Research Subjects

Nontherapeutic Research Procedures Involving Children

Discomfort from Repeated Nontherapeutic Research Procedures Involving Competent Adults

Physicians' Treatment Preferences and Recruitment of Subjects for a Randomized Clinical Trial

Parental Preferences and a Child's Involvement in a Randomized Clinical Trial

Compensating Research Injuries

Physicians, Third Parties, and Society

Request for Surgery the Physician Considers Unnecessary

Providing Free Care

Risk of Litigation as a Factor in Decision Making

Pressures to Provide Customary Care

Confidentiality and Child Abuse

Rejection of a Consultant's Advice

Abortion Resulting in a Live Birth

Costly Nutrition for a Terminal Patient

Cost Factors in the Choice of Treatment for Kidney Stone Disease

Artificial Insemination for a Single Woman

Topical Index to Cases

Table of Contents provided by Publisher. All Rights Reserved.