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Medical Ethics and Bioethics  

These resources examine the topics of medical ethics and bioethics through clinical trials, assisted suicide, stem cells research, informed consent and other topics.
Last Updated: May 1, 2017 URL: http://libguides.nccuslis.org/content.php?pid=709974 Print Guide RSS UpdatesEmail Alerts

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Bioethics and Medical Ethics

Medical ethics is a form of applied ethics that is concerned with moral values and judgments as it applies to medicine.

Bioethics is a philosophical discipline encompassing social, legal, cultural, epidemiological, and ethical issues arising due to advance in healthcare and life science research.

 

Stories That Made History

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Death on Demand - Michael DeCesare
ISBN: 1442242132
Publication Date: 2015-07-01
Death on Demand explores the polarizing role of Jack Kevorkian--"Dr. Death"--as the most visible leader of the right-to-die movement. From a feature on the cover of Time magazine to interviews on shows like 60 Minutes, Kevorkian was a high-profile figure in the right-to-die movement, capturing constant media attention as he helped more than one hundred people kill themselves. The book opens with the death of Janet Adkins in 1990--Kevorkian's first assisted suicide--then travels back to Kevorkian's medical school days and follows his nearly four decades as a lone activist. Death on Demand draws on Kevorkian's interviews and published work as well as newspaper and magazine articles to describe the doctor's publicity stunts, criminal trials, years in prison, and activities after he was paroled.

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Examining Tuskegee - Susan M. Reverby
ISBN: 146960972X
Publication Date: 2013-08-01
The forty-year Tuskegee Syphilis Study, which took place in and around Tuskegee, Alabama, from the 1930s through the 1970s, has become a profound metaphor for medical racism, government malfeasance, and physician arrogance. Susan M. Reverby's Examining Tuskegee is a comprehensive analysis of the notorious study of untreated syphilis among African American men, who were told by U.S. Public Health Service doctors that they were being treated, not just watched, for their late-stage syphilis. With rigorous clarity, Reverby investigates the study and its aftermath from multiple perspectives and illuminates the reasons for its continued power and resonance in our collective memory.

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The Immortal Life of Henrietta Lacks - Rebecca Skloot
ISBN: 1400052181
Publication Date: 2011-03-08
Her name was Henrietta Lacks, but scientists know her as HeLa. She was a poor black woman whose cells were taken without her knowledge in 1951. Her cells became one of the most important tools in medicine--vital for developing the polio vaccine, cloning, gene mapping, and more.  Henrietta's cells have been bought and sold by the billions, yet she remains virtually unknown, and her family can't afford health insurance. This phenomenal New York Times bestseller tells a riveting story of the collision between ethics, race, and medicine, of scientific discovery and faith healing; and of a daughter consumed with questions about the mother she never knew.

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The Case of Terri Schiavo - Kenneth Goodman (Editor)
ISBN: 9780195399080
Publication Date: 2009-10-29
The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the responsibilities of family members, the case also became one of history's most extensively litigated health care disputes.

 

Notable Quotes

"We need people who are committed to caring for people all the way through to their death as if they were family members, committed to relieving their suffering. Sometimes that requires helping people to die."

Timothy E. Quill, MD

 “In quixotically trying to conquer death, doctors all too frequently do no good for their patients’ “ease”, but at the same time they do harm instead by prolonging and even magnifying patients’ dis-ease.”
Jack Kevorkian, Prescription: Medicide: The Goodness of Planned Death

 

The Blurred Lines of Ethics in Medicine and Science

The blurred image is difficult to look upon and it poses even greater difficulty when one attempts to focus.  Equally difficult are the complex and painful choices doctors and families face in the area of medical ethics and bioethics. Turn right? Turn left? Move straight ahead with uncertainty? The playing field is never level; the boundaries are blurred lines, and no one ever has home court advantage. 

At the crossroads of ethics, science and medicine lie the ruins of human life and the salvation of life through human sacrifice. How far should the arms of medicine and science reach in an effort to advance science and research and to save lives?

 

AMA CODE OF MEDICAL ETHICS


AMA PRINCIPLES OF MEDICAL ETHICS

Preamble
The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honorable behavior for the physician.


Principles of medical ethics

  • A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
  • A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
  • A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
  • A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
  • A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
  • A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
  • A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
  • A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
  • A physician shall support access to medical care for all people.

https://www.ama-assn.org/sites/default/files/media.../code-of-medical-ethics-chapter-2.pd...

 

Medical Ethics and History

This short video featuring Dr. David Jones, a Bernard Ackman professor of the culture of medicine, provides a general overview of the history of ethics in this trailer for an academic course in medical ethics.

https://www.youtube.com/watch?v=nPbis0Hggsg#action=share

 

The Four Principles of Health Care Ethics

The four principles of health care ethics developed by Tom Beauchamp and James Childress in the 1985 Principles of Biomedical Ethics provide medical practitioners with guidelines to make decisions when they inevitably face complicated situations involving patients.

The basic definitions of each of the four principles of health care ethics are commonly known and used often in the English language, but they take on special meaning when being utilized in a medical setting. All of these principles play a key role in ensuring optimal patient safety and care.

1. Autonomy: In medicine, autonomy refers to the right of the patient to retain control over his or her body. A health care professional can suggest or advise, but any actions that attempt to persuade or coerce the patient into making a choice are violations of this principle. In the end, the patient must be allowed to make his or her own decisions – whether or not the medical provider believes these choices are in that patient’s best interests – independently and according to his or her personal values and beliefs.

2. Beneficence: This principle states that health care providers must do all they can to benefit the patient in each situation. All procedures and treatments recommended must be with the intention to do the most good for the patient. To ensure beneficence, medical practitioners must develop and maintain a high level of skill and knowledge, make sure that they are trained in the most current and best medical practices, and must consider their patients’ individual circumstances; what is good for one patient will not necessary benefit another.

3. Non-Maleficence: Non-maleficence is probably the best known of the four principles. In short, it means, “to do no harm.” This principle is intended to be the end goal for all of a practitioner’s decisions, and means that medical providers must consider whether other people or society could be harmed by a decision made, even if it is made for the benefit of an individual patient.

4. Justice: The principle of justice states that there should be an element of fairness in all medical decisions: fairness in decisions that burden and benefit, as well as equal distribution of scarce resources and new treatments, and for medical practitioners to uphold applicable laws and legislation when making choices.

http://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care

 

Informed Consent

  • Informed consent to medical treatment is fundamental in both ethics and law.
  • Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.
  • Successful communication in the patient-physician relationship fosters trust and supports shared decision making
  • .The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention. In seeking a patient’s informed consent (or the consent of the patient’s surrogate if the patient lacks decision-making capacity or declines to participate in making decisions), physicians should:. 
     

    a.   Assess the patient’s ability to understand relevant medical information and the implications of treatment alternatives and to make an independent, voluntary decision.

    b.   Present relevant information accurately and sensitively, in keeping with the patient’s preferences for receiving medical information.

    c.    Document the informed consent conversation and the patient’s (or surrogate’s) decision in the medical record in some manner. When the patient/surrogate has provided specific written consent, the consent form should be included in the record.

    https://www.ama-assn.org/sites/default/files/media.../code-of-medical-ethics-chapter-2.pd...

 

Books

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Troubled Voices - Richard M. Zaner
ISBN: 9780829809640
Publication Date: 1993-10-01
Real, in-the-hospital-trenches experiences of medical decision-making. Reminds us that patients are individuals with human needs and concerns, often struggling with choices no one should have to make.

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Informed Consent - Kenneth Getz; Deborah Borfitz
ISBN: 1930624093
Publication Date: 2002-04-01
Informed Consent is a 300-page guidebook designed to assist patients and health consumers in understanding the clinical trial process and their rights as study volunteers. This first-of-its-kind consumers' guidebook provides comprehensive facts and objectives, expert commentary for patients and their advocates to use in order to evaluate whether to include clinical trials among their treatment options. A useful and practical appendix of reference information.

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Biomedical Ethics - Viqi Wagner
ISBN: 9780737737370
Publication Date: 2007-12-13
Issues in biomedical ethics are discussed from a variety of viewpoints.

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Life and Death on Your Own Terms - L. L. Basta
ISBN: 1573929182
Publication Date: 2001-05-01
A readable and insightful book with resources and ideas for assuring dignity and quality care at the end of life. A sensitive, thoughtful and well-reasoned analysis of the ethical considerations and justifications which are relevant to health care directives and medical and family planning at the end stages of life.

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White Coat, Black Hat - Carl Elliot
ISBN: 9780807061428
Publication Date: 2010-09-14
A writer for The New Yorker and The Atlantic Monthly, Carl Elliott, ventures into the uncharted dark side of medicine, shining a light on the series of social and legislative changes that have sacrificed old-style doctoring to the values of consumer capitalism. Taking the pulse of the medical community today, Elliott discovers the culture of deception that has become so institutionalized many people do not even see it as a problem.

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Assisted Suicide: the Liberal, Humanist Case Against Legalization - Kevin Yuill
ISBN: 1137487461
Publication Date: 2013-03-05
This book presents an atheistic case against the legalization of assisted suicide. Critical of both sides of the argument, it questions the assumptions behind the discussion. Yuill shows that our attitudes towards suicide - not euthanasia - are most important to our attitudes towards assisted suicide.

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The Nuremberg Medical Trial - Horst H. Freyhofer
ISBN: 0820467979
Publication Date: 2005-04-26
Following World War II, the American Military Tribunal indicted twenty-three Nazi doctors and administrators for performing agonizing and often fatal experiments on helpless concentration camp inmates. Using primarily court records, this book attempts to answer the following salient questions: What sort of medical experiments did the Nazi doctors perform? Who were their victims, and what was their fate? In trying to answer these questions, Horst H. Freyhofer gives the reader the opportunity to follow the exchanges between prosecutors and defendants as well as the final reasoning of the court.

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Three Generations, No Imbeciles - Paul A. Lombardo
ISBN: 0801898242
Publication Date: 2010-08-31
"Three generations of imbeciles are enough." Few lines from Supreme Court opinions are as memorable as this declaration by Justice Oliver Wendell Holmes Jr. in the landmark 1927 case Buck v. Bell. The ruling allowed states to forcibly sterilize residents in order to prevent "feebleminded and socially inadequate" people from having children. In 1924 Carrie Buck—involuntarily institutionalized by the State of Virginia after she was raped and impregnated & challenged the state's plan to sterilize her. Three Generations, No Imbeciles tracks the notorious case through its history, revealing that it remains a potent symbol of government control of reproduction and a troubling precedent for the human genome era.

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