...Title: Medical Ethics: History and Guiding Principles Author: Alan J. McGoldrick Course: Medicine, Disease and History Instructor: Professor Foss Date: June 15, 2012 Medical ethics are the moral guidelines and ethical laws that help to prioritize a medical professional's work responsibilities. The code of medical ethics outlines the proper conduct between medical professionals and their patients, communities, and colleagues. Each country has a different code of medical ethics, though most contain the same basic principles, and all share the same history of evolution, according to the World Medical Association. Medical ethics refers to the discussion and application of moral values and responsibilities in the areas of medical practice and research. While questions of medical ethics have been debated since the beginnings of Western medicine in the fifth century B.C., medical ethics as a distinctive field came into prominence only since World War II. (Porter, 1998) This change has come about largely as a result of advances in medical technology, scientific research, and telecommunications. These developments have affected nearly every aspect of clinical practice, from the confidentiality of patient records to end-of-life issues. Moreover, the increased involvement of government in medical research as well as the allocation of health care resources brings with it an additional set of ethical questions. Emerging Medical Ethics Through the Ages Ancient Medical Texts ...
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...nursing standards; But as per Maryland nursing standards, she is not working as an advocate for her patient, Mr. E at this situation (Code of Ethics - the Division of State Documents, 10.27.19.02). The patient already signed advanced directive against life saving measures almost seven years ago, at the time of admission to a nursing home, with the help of patient advocate; but Dr G. is planning patient care in opposition to Mr.E’s active advance directive and his expressed objections to the medical care. There are numerous issues to consider in this case study. The nurse has to review her professional role according to code of ethics and nursing standards in relation to advance directives and medical power of attorney. The nurse also has to consider the patient’s right to privacy and confidentiality according to HIPPA Policy. The issues in contemporary healthcare facilities are sometimes the statues can be vague, and issues can be in conflict with own personal beliefs in most areas. A) State Regulations and Nursing Standards of practice There are specific Maryland state regulations and nursing standards regarding patient rights in this case study. However, the most relevant regulation is that, the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient (Nursing code of Ethics: Interpretation and Application, ©2010 Provision 3) 1. Health care workers have to disclose or release patient health information only if...
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...The Snow Storm Lawsuit Candice Kessler Health Care Policy, Law and Ethics Strayer University April 29, 2012 As the chief executive officer of this non-profit community hospital, I would have to consider the legal, ethical and professional aspects of this case. The first legal consideration is duty of responsibility. In a healthcare organization, management functions begin with the senior administration. This includes the chief executive officer. The responsibilities of senior administration include the following duties: support the governing board in its strategic planning and policymaking activities, carry out the board’s policies and strategic goals, communicate board policies and the strategic plan to employees and the medical staff, oversee day-to-day hospital operations, measure the quality of patient care, manage operating funds, select qualified junior executives, and conduct necessary business transactions. Management must report regularly to the governing board on the status of all of these activities (Showalter, 2008). In this case, it could be suggested that I, as CEO, neglected to adequately oversee day-to-day hospital operations which led to the staffing issues. It should also be asked if I reported the issue to the governing board. The second legal consideration is negligence. A healthcare provider can be held liable for the negligence of others, even though he has not been personally negligent. This is called vicarious...
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...Ethical Research Research ethics not only protect the rights of human subjects but also encompass a broader range of principles. The notorious Tuskegee study in Alabama that began in 1932and ended in1972 studied black men with syphilis. The study violated ethical principles in that informed consent was not obtained, confidentiality was violated and treatment was withheld when it became available. The study is well known, because of the tragedy it caused for many people and also because of the sheer lack of ethical consideration shown by the scientists concerned. The United States Public Health Service conducted a study for that began in 1932 and lasted until 1972, not the six months that was expected and is described as "the longest non-therapeutic experiment on human beings in medical history" (Brunner, 2009). The Tuskegee Syphilis Study was conducted from 1932 to 1972 around Tuskegee, Alabama. Six hundred poor, and mostly illiterate, African-American males, 400 of whom were infected with syphilis, were monitored for 40 years. Free medical examinations were given; however, subjects were not told about their diagnosis. Even though a cure (penicillin) became available in the 1950s, the study continued until 1972 with participants being denied proper treatment or given fake treatments and placebos, instead. In some cases, when subjects were diagnosed as having syphilis by other physicians, researchers intervened to prevent treatment. Many of the subjects died slow and painful...
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...Syphilis Study Tammy Warner Grand Canyon University Ethics September 10, 2014 Research Work and The Tuskegee Syphilis Study Much of what we learn in life, we learn from other people. This can be accomplished by learning from other people’s mistakes or we can learn from making our own. This author prefers to learn from other people in hopes of not making a bigger mistake. There are many things that we can learn from The Tuskegee Study of Untreated Syphilis in the Negro Male (Smith, 1999). The author would like to explore the ethical issues that were violated to recruit and retain participants in this study and how they are still affecting our profession today as well as how the public views the profession of nursing. History of the Study The Tuskegee Study began in 1932 with approximately 400 sharecroppers who had late stage untreated syphilis. The study included 200 controls that were free of the disease. The 200 men were never told they had syphilis. These men were only told they were in a study but not told what that really meant. According to Harold Edgar (1992) the Tuskegee study was not only an example of a scientific misconduct, but was ethically wrong from the start and was built upon deception. It was a study in which poor, illiterate black men had been deceived into thinking they were being taken care of (Caplin, 1992). As incentives to enter the program, these men were promised free medical care, free hot lunches, and free burial after autopsies...
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...Press 0521804167 - Euthanasia, Ethics and Public Policy: An Argument Against Legalisation John Keown Frontmatter More information EUTHANASIA, ETHICS AND PUBLIC POLICY An Argument against Legalisation Whether the law should permit voluntary euthanasia or physicianassisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain hard cases, voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a slippery slope to the killing of patients who did not make a free and informed request, or for whom palliative care would have offered an alternative. How cogent is this objection? This book provides the general reader (who need have no expertise in philosophy, law or medicine) with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest readers in any country, whether for or against legalisation, who wish to ensure that their opinions are better informed. john keown is Senior Lecturer in the Law and Ethics of Medicine, Faculty of Law, University of Cambridge. His previous publications include Abortion, Doctors and the Law (1988) and Euthanasia Examined (1995). © Cambridge University Press www.cambridge.org Cambridge University Press 0521804167 - Euthanasia, Ethics and Public Policy: An Argument...
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...be a right to life in the true sense of the term. But there is a legal battle going on in America right now over whether or not a person has a right to die. Does the government have the right to prolong your life by artificial means whether you desire it or not? With the passing of this law nationwide, you, as the voter will simply be saying, “It is YOUR choice” (Patashnik, 2004) The issue of “Having a Personal Right to Die,” has been long simmered beneath the surface in legal and political circles: under what circumstances do terminally injured and ill Americans have the right to choose to die? The Supreme Court made a definitive statement in the landmark 1990 case Cruzan v. Director, Missouri Dept. of Health that severely injured patients have a constitutional right to refuse medical treatment and die. But the court also ruled that states can require "clear and convincing" evidence of a patient's intent to forgo medical treatment, a rather high evidentiary standard to meet. History The actual word for “having a right to die” is Euthanasia. According to Dictionary.com, euthanasia is defined as the practice of intentionally ending a life in order to relieve pain and suffering. The concept of Euthanasia goes as far back as 1870, when Samuel Williams, a schoolteacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club, which was subsequently published in a one-off publication...
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...From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human subjects involved in a research project, what the goals of research ought to be, and what ought to constitute proper procedure for an ethical research. These issues are central to an aspect of applied ethics which is now commonly referred to as research ethics. The aim of research ethics is to ensure that research projects involving human subjects are carried out without causing harm to the subjects involved. In addition, it provides a sort of regulatory framework which ensures that human participants in research are not exploited either physically or psychologically. The need for ethical guidelines...
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...principles to protect human participants in biomedical research from undue exploitation by researchers. However, in the “Tuskegee Study” in the US, these principles were grossly violated. The task of this paper is to critically examine the ethical implications of that study on future practices in biomedical research, and to suggest ways of ensuring that such practices comply with appropriate ethical values. Key Words Bioethics, Biomedical research, clinical research, Tuskegee Study, paternalism, morality Introduction From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human...
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...CASE SCENARIO Leo R. is a 45-year-old patient with diabetes and is a widower with three young children. Two of Leo’s children suffer from chronic medical conditions. His oldest daughter, like Leo, has insulin-dependent diabetes. His only son suffers from grand mal epilepsy, which is poorly controlled by a plethora of medications. Leo works for a small printing business, a job he enjoys, but one that makes it difficult for him to make ends meet. With only six employees, the company’s owner cannot afford to offer health insurance. Leo’s annual salary of $30,000 allows him to purchase only the most basic of health plans, one that does not include coverage for prescription medications. Leo frequently must decide between medications and food, often opting for cheap junk food that is neither nutritious for his young family nor appropriate for a diabetic diet. Leo has recently applied for and been offered several other jobs, but at a lower salary and with no health insurance coverage. Recently, Leo’s diabetes has worsened. He has developed a serious infection that has led to lost wages and, far worse, the loss of his right leg below the knee. Leo is weighing his options. He has heard about a new clinical research trial open to insulin-dependent diabetics that pays $100 a week to research subjects. He has also been quite depressed and begun to wonder if his children might not be better off without him. He has several life insurance policies that would pay off generously if something...
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...technology have provided patients with an array of treatment options as well as assumed or possible increased chance of survival. As a result, nurses are met with a rise in ethical decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to the Patient’s Ethics Committee. Referring the family to the committee allows the family to make the final decision of what would be the most favorable outcome for the patient. The critical thinking exercise, however has more of an individual ethical dilemma. This includes the ethical principles of justice and veracity. She should reflect on her own values to determine what...
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...Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care (Fine, 2005) On March 31, 2005, Terri Schiavo (born December 3, 1963) died -- the final complication of a cardiac arrest on February 25, 1990. Her death was preceded by the withdrawal of artificially administered hydration and nutrition through a feeding tube. Prior to her death, Terri's saga was the focus of intense medical, ethical, and legal debates in the United States and elsewhere. These debates were characterized by confusion about the facts, ethical principles, and laws relevant to the case. Much of the confusion revolved around a number of ethical and legal questions including: Is it ethically and legally permissible to withhold or withdraw life-sustaining treatments from patients who do not want the treatments? Is withholding or withdrawing life-sustaining treatments the same as physician-assisted suicide or euthanasia? Is artificially administered hydration and nutrition a medical treatment or mandatory care akin to bathing? What were Terri's values, preferences, and goals regarding life-sustaining treatments? Several issues raised...
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...advanced directive. Her husband and children cannot come to an agreement on whether life support should end or if all resuscitative measures should be attempted. The following paper will discuss how the American Nurse’s Association Code of Nursing Ethics would influence a final decision, how personal and societal values can influence ethical decision making, the fundamental legal aspects of each case study, and the legal responsibilities of nurses in the work setting. Regardless of any situation that may arise, every nurse has a set standard in place that must be followed. These are nonnegotiable, ethical standards, obligations and duties that every individual swears to when entering the nursing profession. These standards are all found within the American Nurses Association’s code of Nursing Ethics and Conduct. Whether dealing with patients and families during end of life decision making or dealing with nursing negligence within the court of law, the first provision in the code of ethics is the most imperative to remember. Nurses are always obligated to their patient’s best interest, therefore making them an unrelenting patient advocate. Many provisions are pointed out within the Nursing Code of Ethics. In the situation of dealing with Marianne’s family and medical treatments, there are many important things to consider. “The nurse respects the worth, dignity, and rights of all human beings irrespective of the nature of the health problem. The worth of the person is...
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...ethical principles to protect human participants in biomedical research from undue exploitation by researchers. However, in the “Tuskegee Study” in the US, these principles were grossly violated. The task of this paper is to critically examine the ethical implications of that study on future practices in biomedical research, and to suggest ways of ensuring that such practices comply with appropriate ethical values. Key Words Bioethics, Biomedical research, clinical research, Tuskegee Study, paternalism, morality Introduction From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human subjects involved in...
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...effects of untreated syphilis on African-American men for a duration of six to nine months and then follow-up with a treatment plan. A total of 600 African American men were enrolled in the study, 399 men with syphilis and 201 men without the infection. Syphilis is a highly contagious disease caused by the bacteria Treponema pallidum transmitted sexually or congenitally...
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