book is its depth of analysis as the philosophical, social, and economic issues of managed care are developed. The book will be of interest to educated readers in their role as patients and to all levels of medical and health care professionals.  (less)

to be familiar with to practice medicine in an acceptable way. The book uses many real-life cases -- some simple, some challenging -- that will help illustrate the application of modern ethics to everyday practice. Professionals in other health disciplines may find this bo useful as the key issues discussed are often faced by them as well.brDr. Philip Hebert obtained his PhD in philosophy from York University and his MD from the University of Toronto. He is currently Assistant Professor with the Department of Family and Community Medicine at the University of Toronto, Bioethics Coordinator of the undergraduate curriculum at the University of Toronto Medical School, and attending physician at the Sunnybrook Health Science Centre. Dr. Hebert also holds cross appointments in the Department of Extended Care (Sunnybrook Health Science Centre) and the Department of Philosophy (University of Toronto).brbrIntroductionbr1. Principles Behind Ethically Sound Medicinebr1.1. Ethical Reasoning and Principles in Medicinebr1.2. Three Ethical Principles and Questionsbr1.3. Resolving Ethical Dilemmasbr1.4. A Good Enough Ethics Decision Procedurebr1.5. A Starving Patient with Anorexia: To Feed or Not to Feed?br2. Autonomy and Patient Carebr2.1. The Autonomy Principlebr2.2. The Case of Mrs. Malette and Dr. Shulmanbr2.3. Living Wills: Choices of Autonomy Pastbr2.4. Unhealthy Choicesbr2.5. Difficulty with the Autonomy Modelbr3. Confidentiality and Its Limitsbr3.1. Confidentialitybr3.2. Secrets and Privacybr3.3. Limits to Confidentialitybr3.4. Duty to Warnbr3.5. Whistle Blowingbr4. Truth, Lies and Deception in Clinical Practicebr4.1. The Role of Disclosurebr4.2.@E€  (less)

an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care. In this formulation, physician beneficence and responsibility become powerful means for supporting the autonomy and dignity of patients. Beneficence, Tauber argues, should not be confused with the medical paternalism that fueled the patient rights movement. Rather, beneficence and responsibility are moral principles that not only are compatible with patient autonomy but strengthen it. Coordinating the rights of patients with the responsibilities of their caregivers will result in a more humane and robust medicine. Tauber examines the historical and philosophical competition between facts (scientific objectivity) and values (patient care) in medicine. He analyzes the shifting conceptions of personhood underlying the doctor-patient relationship, offers a ""topology"" of autonomy, from Locke and Kant to Hume and Mill, and explores both philosophical and practical strategies for reconfiguring trust and autonomy. Framing the practicalities of the clinical encounter with moral reflections, Tauber calls for an ethical medicine in which facts and values are integrated and humane values are deliberately included in the program of care."  (less)

are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issue involved in clinical medical ethics. Since the analysis of cases plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of Medical Ethics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions.br1. Paternalism in the Therapeutic Relationshipbr2. Duties to Patient and Familybr3. Deciding for Othersbr4. Medical Research Involving Human Subjectsbr5. Physicians, Third Parties, and SocietybrTopical Index to CasesbrbrAbout the AuthorsbrTerre@9ŸQë…ÿ¾Û€  (less)

confront a range of possible consequences. A two-year-old has been diagnosed with a malignant brain tumor. Who should be allowed to make decisions about the child's surgery and subsequent therapy, and on what basis? A family history of Huntington's disease emerges when a fiancee seeks genetic counseling. Who should be informed? An elderly patient suffers a cardiac arrest. Should do-not-resuscitate orders always be followed? How should legal liability affect medical decisions?brOther ethical issues considered include surgical complications, patient autonomy, rights of the retarded, informed consent, euthanasia, and the fair allocation of finite resources. Each case presented conveys the drama and pressure of weighing alternatives, and the realistic consequences of the choices made. The authors show that ethical decision-making is not limited to matters of life and death, and that it is not the decision but the ethical process by which it is made that gives the decision moral integrity. With realistic detail, Tough Decisions brings to life and makes the student share in the many complexities of ethical decision-making when the health and lives of patients are at stake.br1. Maggie: Should a patient's request not to be resuscitated always be followed?br2. Monica: Can a father refuse treatment of his toddler's brain tumor?br3. Leroy: Who will care for this 83-year-old after his cataract surgery?br4. Joey, Jessica, Roger, Tom & Marti: Who should be moved from the crowded ICU to make space for new patients?br5. Tom Revisited: Who should decide to stop treatment? When and how?br6. Marti Revisited: Should a quadriplegic 12-year-old be allowed to give up?br7. Edgar ?è  (less)

in the ward—how definitions of right and wrong emerge from the social situations of patients, families, doctors, and nurses and from the workings of hospitals and the courts.BRBRHis book is a portrait of the way careful planning is undermined by the unpredictability of illness and the persistence of self-interest, by high principle and curious compromise.BR/divDIVAcknowledgmentsBR1: Medical Ethics and the Medical ProfessionBR2: Intensive CareBRiPt. 1: The Moral Order of Intensive Care/iBR3: The PatientBR4: Doctors: The Banality of HeroismBR5: The Nurse's DilemmaBR6: Patienthood and the Culture of RightsBR7: Patients and FamiliesBRiPt. 2: Medical Ethics: Triage and the Limitation of Treatment/iBR8: Penguins in the BasementBR9: Uncertainty, the Social Organization of Medicine, and Limitation of TreatmentBR10: Withholding, Withdrawing, and the Terminal PatientBR11: Ethics, Families, and Technical ReasonBR12: The Do Not Resuscitate Order as RitualBR13: A Legal ThingBR14: The Last BedBR15: Medicine's Two CulturesBRAppendix: On MethodBRGeneral IndexBRIndex of Doctors, Nurses, Patients, and Families of Patients/divDIVBRobert Zussman/Bis professor of sociology at the University of Massachusetts, Amherst.BR/DIV  (less)

often thought of as being separate, if not opposed (virtue-based ethics and universal human rights). The case is argued gracefully, with moderation, but also with respect for opposing positions.  (less)

entirety. and a significant number would be difficult to obtain elsewhere.br /br /The volume draws upon the literature of history. medicine. philosophical and religious ethics. economics. and sociology. A wide range of topics and issues are covered, such as law and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber.br /br /Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction.br /br /The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine.  (less)

of time and resources on medical care for people near the end of their lives; yet, Americans do not live significantly longer than citizens of other Western countries. What are the motivations of this death-denying culture? How can we deal with the complexities of medical care as life unavoidably comes to a close? How can we resolve the controversies that complicate medical decisions in the presence of advanced age or end-stage disease? A Graceful Exit: Life and Death on Your Own Terms addresses the difficult issue inherent to an aging society - the right to control one's death. Many Americans are executing living wills to be spared the indignities of futile medical treatment. Current living wills, however, have proven to be nearly useless in guiding care. Dr. Lofty Basta, a renowned physician specializing in cardiology, frankly explains that most patients of advanced age or disease are incompetent to make health care decisions, or incapable of evaluating treatment options. This book provides examples of living wills that are clear, valid, and applicable to many medical situations, and is supported by intimate case histories that illustrate various problems. As a sidebar, the author relates how different Western countries are dealing with this controversial issue. A Graceful Exit is a provocative resource to the medical community, hospital administrators or members of ethics committees, politicians, the clergy, civic leaders, and all who wish to control their medical treatment near the end of life./Div  (less)

client consultation and the most important components of a client care plan. They will also gain valuable advice about developing and maintaining positive working relationships with physicians. From clinician ethics to patient rights, this book helps the reader advance professionally by educating them about these important components of the business. Features: Advice on working with clients and physicians helps clinicians succeed in their work Discussions of client rights and clinician ethics delve into subjects not commonly addressed Table of Contents: Chapter 1: Consultations Chapter 2: Client Care Plans Chapter 3: Managing Complications Chapter 4: Social Perceptions and Active Listening Chapter 5: Developing a Rapport with a Physician C...  (less)