Resolving Ethical Dilemmas A Guide for Clinicians

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  • Edition: 4th
  • Format: Paperback
  • Copyright: 2009-01-07
  • Publisher: LWW
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This timely Fourth Edition offers clinicians expert guidance in approaching a wide range of ethical dilemmas and developing an action plan. Most chapters include real-life sample cases that the author walks through, discussing the salient issues and how to approach them. This edition includes a new chapter on ethical issues in cross-cultural medicine and new material on conscientious objection by physicians in reproductive health and other areas. Other topics addressed include disclosure of errors to patients, gifts to physicians from drug companies, involuntary psychiatric treatment, genomic medicine, and ethical issues during public health emergencies such as pandemics. The updated discussion of organ transplantation includes increasing the donor pool and non-heart beating donors.

Author Biography

Bernard Lo, MD, FACP, Professor of Medicine, Director, Program in Medical Ethics, University of California, San Francisco, Attending Physician, Moffitt-Long Hospital, San Francisco, California

Table of Contents

Preface to the First Editionp. v
Preface to the Fourth Editionp. vii
Fundamentals of Clinical Ethics
An Approach to Ethical Dilemmas in Patient Carep. 3
Overview of Ethical Guidelinesp. 11
Informed Consentp. 18
Promoting the Patient's Best Interestsp. 31
Confidentialityp. 40
Avoiding Deception and Nondisclosurep. 50
Keeping Promisesp. 61
Shared Decision Making
An Approach to Decisions About Clinical Interventionsp. 67
Futile Interventionsp. 69
Decision-Making Capacityp. 75
Refusal of Treatment by Competent, Informed Patientsp. 83
Standards for Decisions When Patients Lack Decision-Making Capacityp. 88
Surrogate Decision Makingp. 101
Persistent Disagreements Over Carep. 107
Decisions About Life-Sustaining Interventions
Confusing Ethical Distinctionsp. 119
Ethics Consultations and Ethics Committeesp. 129
Do Not Attempt Resuscitation Ordersp. 136
Tube and Intravenous Feedingsp. 145
Physician-Assisted Suicide and Active Euthanasiap. 151
The Persistent Vegetative Statep. 162
Determination of Deathp. 166
Legal Rulings on Life-Sustaining Interventionsp. 170
The Doctor-Patient Relationship
Overview of the Doctor-Patient Relationshipp. 179
Refusal to Care for Patientsp. 182
Gifts from Patients to Physiciansp. 190
Sexual Contact Between Physicians and Patientsp. 195
Secret Information About Patientsp. 201
Clinical Researchp. 203
Conflicts of Interest
Overview of Conflicts of Interestp. 213
Bedside Rationing of Health Carep. 219
Incentives for Physicians to Increase Servicesp. 227
Measures to Control Health Care Costsp. 230
Gifts from Drug Companiesp. 238
Disclosing Errorsp. 243
Impaired Colleaguesp. 251
Ethical Dilemmas Students and House Staff Facep. 256
Ethical Issues in Clinical Specialties
Ethical Issues in Pediatricsp. 267
Ethical Issues in Surgeryp. 278
Ethical Issues in Obstetrics and Gynecologyp. 285
Ethical Issues in Psychiatryp. 293
Ethical Issues in Organ Transplantationp. 301
Ethical Issues in Genomic Medicinep. 311
Ethical Isues in Public Health Emergenciesp. 321
Ethical Issues in Cross-Cultural Carep. 330
Cases for Discussionp. 339
Indexp. 351
Table of Contents provided by Ingram. All Rights Reserved.

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