Emerging issues in medical ethics

Article Abstract:

Historically, health care systems have been hierarchically organized. Doctors, who were usually male, were viewed as informed, authoritarian dominating forces. Today, although there are more women who are doctors, their relative absence from policy-making positions has preserved this paternalistic style. The limits of medical paternalism have now become a battleground, particularly in relation to abortion, treatment of breast cancer, and heart disorders. Research has indicated a bias when it comes to choosing suitable patients for heart transplant or bypass surgery: women and minority-group patients are less frequently offered the option of such procedures. Paternalistic research policies such as banning the use of fetal tissue for research are also widespread. This particular policy has been upheld in the United States because it was presumed that women would seek more abortions if they felt that good use could be made of their aborted fetuses - a supposition which has never been supported by research data. The concept of informed consent is also being questioned, since some patients' inability to fully understand the jargon used by doctors and insurers may preclude their being truly informed. In-vitro fertilization, artificial insemination and surrogate motherhood have also raised questions about the role of biological versus social parenting, children's rights, and the nature of informed consent. For instance, a surrogate mother may not be able to make an informed decision because she cannot predict future maternal feelings. Substance abuse during pregnancy has also stirred controversy. In some states, pregnant alcoholics and drug addicts are jailed, pitting the mother's autonomy against the best interests of the fetus. Sexual intimacy between doctors and patients is another current concern. Since patients often have warm and trusting feelings towards their doctors, an analogy between doctor-patient sex and incest has often been made. Many of these and other concerns remain unreconciled so that patient-doctor relationships require more stringent evaluations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Ethical aspects, Women in medicine

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Ethics

Article Abstract:

Ethics, according to a dictionary definition, is 'a principle of right or good conduct; the study of the general nature of morals and of the specific moral choices to be made by the individual in his relationship with others.' Ethical questions are often answered according to a belief or lack of belief in God, and the consequences that result from that conviction. The medical profession is plagued by ill-conceived practices based on an atheistic belief that there is no God, and therefore no ultimate accountability. The ''Revelation Theory'' of ethical conduct places the determination of right and wrong above man. According to this belief, God tells man the principles by which life can attain its greatest potential. America was built on this theory of ethics, in which the Bible was infallible in matters of conduct. The author believes this theory to be an absolute, and states that God's love for us is not based on situational ethics, but he loves us all the time, and we in return love him for that, and obey his commandments. These commandments say to do good to all, to love your neighbor as yourself, and to choose not to return evil with evil. Man does not perfectly attain this standard, because he is human, but lets go of the past and continually strives to do better. These theories are all based on biblical teachings, which the author believes must be closely matched to achieve the distinction expressed by Dr. Lou Sportelli, ''ethics is that fragile fiber that separates man from beast, it is...the Voice of God.'' (Consumer Summary produced by Reliance Medical Information, Inc.)

Beliefs, opinions and attitudes, Ethics, editorial

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Ethics Manual, Fourth Edition

Article Abstract:

The Fourth Edition of the Ethics Manual of the American College of Physicians may help physicians grapple with the difficult ethical issues of 21st Century medicine. It covers disclosure, informed consent, and confidentiality. Alternative medicine, genetic testing, end-of-life decisions, advance directives, physician-assisted suicide, and euthanasia are also discussed. Physicians can also find information about financial conflicts of interest, advertising, resource allocation, consultation, peer review and physician impairment.

Reports, American College of Physicians

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