Ethical issues facing anesthesiologists are more far-reaching than those involving virtually any other medical specialty. In this clinical ethics textbook, authors from across the USA, Canada and Europe draw on ethical principles and practical knowledge to provide a realistic understanding of ethical anesthetic practice. The result is a compilation of expert opinion and international perspectives from clinical leaders in anesthesiology. Building on real-life, case-based problems, each chapter is clinically focused and addresses both practical and theoretical issues. Topics include general operating room care, pediatric and obstetrical patient care, the intensive care unit, pain practice, research and publication, as well as discussions of lethal injection, disclosure of errors, expert witness testimony, triage in disaster and conflicts of interest with industry. An important reference tool for any anesthesiologist, whether clinical or research-oriented, this book is especially valuable for physicians involved in teaching residents and students about the ethical aspects of anesthesia practice.

Preface
Consent and Refusal
Informed consent: respecting patient autonomy
Informed refusal: DNR orders in the patient undergoing anesthesia and surgery, and at the end of life
Informed refusal - the Jehovah's Witness patient
Surrogate decision-making
Informed consent and the pediatric patient
Do not resuscitate decisions in pediatric patients
Consent in laboring patients
Maternal-fetal conflicts: Cesarian delivery on maternal request
Consent for anesthesia for procedures with special societal implications: psychosurgery and electroconvulsive therapy
Ethical use of restraints
The use of ethics consultation regarding consent and refusal
Consent and cultural conflicts: ethical issues in pediatric anesthesiologists' participation in female genital cutting
Communitarian values in medical decision-making: Native Americans
Informed consent for perioperative testing: pregnancy testing and other tests involving sensitive patient issues
End-of-Life Issues
The principle of double effect in palliative care: euthanasia by another name?
Surgical interventions near the end of life: 'therapeutic trials'
Withholding and withdrawing life support in the intensive care unit
Discontinuing pacemakers, ventricular assist devices and implanted cardioverter-defibrillators in end-of-life care
Brain death
Ethical issues in organ donation after cardiac death
Revising the uniform anatomical gift act: the role of physicians in shaping legislation
Physician aid in dying and euthanasia
Pain Management
Ethical considerations in interventional pain management
Conjoining interventional pain management and palliative care: considerations for practice, ethics and policy
Opioid therapy in addicted patients: background and perspective from the United Kingdom
Opioid therapy in addicted patients: background and perspective from the United States
Research and Publication
Ethics in anesthesiology research using human subjects
Animal subjects research part I: do animals have rights?
Animal subjects part II: ethics of animal experimentation
Ethical function of human subjects review boards: a United States perspective
Research with vulnerable patients such as children and prisoners
The ethics of research on pain and other symptoms for which effective treatments already exist
Quality improvement initiatives: when is quality improvement actually a form of human subjects research?
Conflicts of interest in research funding
Publication ethics: obligations of authors, peer-reviewers and editors
Practice Issues
The impaired anesthesiologist - addiction
The impaired anesthesiologist - sleep deprivation
Ethical considerations regarding the disabled anesthesiologist
The abusive and disruptive physician
Sexual harrassment, discrimination and faculty-student intimate relationships in anesthesia practice
Conflicts of interest - industry gifts to physicians
Disclosure of medical errors in anesthesiology practice
Physician conscientious objection in anesthesiology practice
Anesthesiologists, the State, and Society
The ethics of expert testimony
Ethical principles regarding physician response to disasters: pandemics, natural disasters and terrorism
Triage in civilian mass casualty situations
Triage and treatment of wounded during armed conflict
Physician facilitation of torture and coercive interrogation
Physician participation in execution
Index
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