Ethics

Depending on our mode of reasoning-moral, prudential, instrumental, empirical, dialectical, and so on-we may come to vastly different conclusions on the nature of death and the appropriate orientation toward matters such as euthanasia or procuring organs from brain-dead patients. These differing orientations have resulted in some of the most enduring conflicts in biomedical decision-making with roots in the earliest strands of philosophical discourse. Through continually grappling with questions over matters of death, we continually step closer to clarity, even if certainty on these matters remains necessarily as elusive as death itself...

BACKGROUND: Healthcare is permeated by phenomena of vulnerability and their ethical significance. Nonetheless, application of this concept in healthcare ethics today is largely confined to clinical research. Approaches that further elaborate the concept in order to make it suitable for healthcare as a whole thus deserve renewed attention. METHODS: Conceptual analysis. RESULTS: Taking up the task to make the concept of vulnerability suitable for healthcare ethics as a whole involves two challenges...

This extended essay seeks to unpack some of the key aspects of philosophy which are applicable to medical thought and practice. It proceeds via an analytical discussion of the contemporary debate in three key areas of medical ethics: euthanasia, concepts of health & disease and psychiatry.The main claims are as follows: 1. The case for legalising euthanasia is strong on philosophical grounds but there are numerous practical obstacles. 2. Elements from the normative and naturalistic definitions of disease are necessary for a thorough definition that dodges common objections to either...

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Bioethics comes in for furious criticism in Stephen Pinker's new book, Enlightenment Now. Pinker argues that scientists are making human lives better and better, and that lives would get still better even faster if bioethicists did not use ideas like informed consent, dignity, sacredness, and social justice to hobble the scientists. Daniel Callahan, a cofounder of The Hastings Center and arguably of bioethics, is perhaps the best living embodiment of a bioethicist who has written about medical progress, and the March-April 2018 issue of the Hastings Center Report turns to him for a review of Pinker's book...

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use...

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BACKGROUND: Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR. OBJECTIVE: A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways...

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Social media sites have become powerful and important tools for health education, promotion, and communication activities as they have dramatically grown in popularity. Social media sites also offer many features that can be used for professional development and advancement. When used wisely and prudently, social media sites and platforms offer great potential for professional development by building and cultivating professional networks, as well as sharing information to increase one's recognition and improve one's reputation...

Given the long-standing controversy about whether the brain-dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain-dead loved one continues to receive supportive care. We argue that while it would be ethically inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings...

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He's the first patient of the day: admitted overnight, he's scheduled for surgery this morning. "Do you want to catch him before or after?" the resident asks. "Is there anything we need to do for him right away?" I say. When she says that the night resident mentioned some pain issues, I decide to..