Table of Contents
Introduction 1
The Four Topics 3
Ethical Reasoning in Clinical Ethics 4
Resources in Clinical Ethics 7
Acknowledgments 8
Bibliography 8
The Four Topics Chart 9
Topic 1 Medical Indications 11
1.1 Indicated and Nonindicated Interventions 20
1.2 Clinical Judgment and Clinical Uncertainty 26
1.3 Cardiopulmonary Resuscitation and Orders not to Resuscitate 33
1.4 Medical Error 46
1.5 Determination of Death 47
1.6 Summary 50
Topic 2 Preferences of Patients 53
2.1 Informed Consent 58
2.2 Decisional Capacity 73
2.3 Decision-Making for the Mentally Incapacitated Patient 89
2.4 Surrogate Decision Makers 97
2.5 Failure to Cooperate in the Therapeutic Relationship 104
Topic 3 Quality of Life 115
3.1 Divergent Evaluations of Quality of Life 123
3.2 Enhancement Medicine 132
3.3 Compromised Quality of Life and Life-Sustaining Interventions 134
3.4 Pain Relief for Terminally Ill Patients 152
3.5 Medically Assisted Dying 158
3.6 Suicide 166
Topic 4 Contextual Features 169
4.1 Health Professions 173
4.2 Other Interested Parties 180
4.3 Confidentiality of Medical Information 185
4.4 Economics of Clinical Care 193
4.5 Allocation of Scarce Health Resources 201
4.6 Influence of Religion on Clinical Decisions 216
4.7 Role of Law in Clinical Ethics 219
4.8 Clinical Research and Education 220
4.9 Public Health 232
4.10 Organizational Ethics 241
Index 249
