Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, Sixth Edition

by Jonsen, Albert R.; Siegler, Mark; Winslade, William J.

• ISBN13: 9780071441995
• ISBN10: 0071441999
• Edition: 6th
• Format: Paperback
• Copyright: 2006-04-26
• Publisher: McGraw-Hill Medical

Summary

Clinical Ethics introduces the four-topics method of approaching ethical problems (i.e., medical indications, patient preferences, quality of life, and contextual features). Each of the four chapters represents one of the topics. In each chapter, the authors discuss cases and provide comments and recommendations. The four-topics method is an organizational process by which clinicians can begin to understand the complexities involved in ethical cases and can proceed to find a solution for each case.

Author Biography

Albert R. Jonsen, PhD: Professor Emeritus of Ethics in Medicine, School of Medicine, University of Washington. Seattle, WA

Mark Siegler, MD: Lindy Bergman Distinguished Service Professor of Medicine; and Director, MacLean Center for Clinical Medical Ethics, University of Chicago, IL

William J. Winslade, PhD, JD: University of Texas Medical Branch, Galveston; and Distinguished Visiting Professor of Law, University of Houston, Health, Law, and Policy Institute, TX

Table of Contents

INTRODUCTION	1	(12)
The Four Topics: Case Analysis in Clinical Ethics	1	(9)
References	10	(1)
The Four Topics Chart	11	(2)
CHAPTER 1 Indications for Medical Intervention	13	(38)
1.1 Indicated and Nonindicated Interventions	24	(13)
1.2 Orders Not To Resuscitate (DNR)	37	(9)
1.3 Legal Implications of Forgoing Treatment	46	(1)
1.4 Determination of Death	47	(4)
CHAPTER 2 Preferences of Patients	51	(58)
2.1 Informed Consent	54	(6)
2.2 Decisional Capacity	60	(5)
2.3 Beliefs Due To Religious and Cultural Diversity	65	(1)
2.4 Truthful Communication	66	(7)
2.5 Competent Refusal of Treatment	73	(10)
2.6 Advance Planning	83	(5)
2.7 Decision Making for the Mentally Incapacitated Patient	88	(12)
2.8 The Limits of Patient Preferences	100	(1)
2.9 Failure To Cooperate With Medical Recommendations	101	(5)
2.10 Alternative Medicine	106	(3)
CHAPTER 3 Quality of Life	109	(50)
3.1 Enhancing Quality of Life	123	(8)
3.2 Compromised Quality of Life and Life-Sustaining Interventions	131	(15)
3.3 Euthanasia and Assisted Suicide	146	(8)
3.4 Care of the Dying Patient	154	(1)
3.5 Suicide	155	(4)
CHAPTER 4 Contextual Features	159	(64)
4.1 Role of Other Interested Parties	166	(5)
4.2 Confidentiality of Medical Information	171	(7)
4.3 The Economics of Clinical Care	178	(11)
4.4 Allocation of Scarce Health Resources	189	(9)
4.5 Influence of Religion on Clinical Decisions	198	(2)
4.6 The Role of the Law in Clinical Decisions	200	(3)
4.7 Clinical Research	203	(9)
4.8 Clinical Teaching	212	(3)
4.9 Occupational Medicine	215	(1)
4.10 Public Health	216	(2)
4.11 Ethics Committees	218	(2)
4.12 Ethics Consultation	220	(3)
Locator	223