Easier Said Than Done: Moral Decisions in Medical Uncertainty

Overview

For nearly two decades medical ethics has matured in the fields of philosophy, religion and theology, and psychology. But now, at last, in Easier Said Than Done, a practicing physician describes the principles of an ethic that can justify sound medical decisions. Milton D. Heifetz, M.D., noted neurosurgeon and author of the controversial book The Right To Die, has made the tough decisions in tragic, often anguishing situations. As a member of hospital ethics committees for many years, Dr. Heifetz found that ...
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Overview

For nearly two decades medical ethics has matured in the fields of philosophy, religion and theology, and psychology. But now, at last, in Easier Said Than Done, a practicing physician describes the principles of an ethic that can justify sound medical decisions. Milton D. Heifetz, M.D., noted neurosurgeon and author of the controversial book The Right To Die, has made the tough decisions in tragic, often anguishing situations. As a member of hospital ethics committees for many years, Dr. Heifetz found that discussions of complex issues - many involving urgent matters of life and death - were all too often clouded by tradition, dogma, and gut reactions. A comprehensive moral foundation with the flexibility to respond to often rapidly changing circumstances is desperately needed if health-care professionals are to confront head-on the daily questions of medical ethics. Dr. Heifetz offers it here in a book that he hopes will help all who must make difficult medical choices: physicians and nurses as well as patients and their families. His insights will also prove invaluable to policy makers who are struggling to develop substantive rules for medical conduct.
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Editorial Reviews

Publishers Weekly - Publisher's Weekly
Confronting challenging medical-ethical questions, Heifetz ( The Right to Die ) takes controversial stands which he supports with reasoned arguments. Advocating self-determination and the avoidance of harm to self, family and community, he suggests that principles of non-maleficence, patient autonomy, the common good and beneficence be weighed and prioritized in any given situation. After laying the philosophical foundation for his positions in a turgid first chapter, he brings the text to life with case histories and examples, discussing doctor-patient relationships, abortion, suicide, euthanasia and other issues. Heifetz believes euthanasia is a morally justifiable choice but must be monitored by ethics committees, and argues that women have the right to decide whether to have abortions. Illuminating the legal dilemmas faced by doctors who are struggling at the same time with ethical and social issues, Heifetz offers concrete proposals for legislation in various related areas in his useful, provocative book. (July)
Library Journal
The title accurately describes both the stickiness of moral dilemmas in medicine and the difficulty of fulfilling this book's stated goal of providing ``four factors . . . that when properly balanced by `dispassionate' reason and applied to a given situation should result in a decision which is morally correct.'' Still, Heifetz's experience as a neurosurgeon serves him well as he carefully analyzes the doctor-patient relationship and such key concepts as ``harm,'' ``rights,'' ``informed consent,'' ``confidentiality,'' and ``substituted judgment.'' In the opening chapters, which are the strongest, Heifetz develops four useful principles as a framework for ethical decision making: nonmaleficence, freedom, the common good, and beneficence. He then applies them to specific problems such as suicide, abortion, the ``tragic newborn,'' euthanasia, human experimentation, and triage, with sometimes startling conclusions, such as the proposal for ``prisoner suicide.'' Marred by occasional wordiness, this book would have been strengthened by the use of case studies from Heifetz's own experience. Recommended for large bioethics collections.--Carol Watwood, Western Kentucky Univ. Lib., Bowling Green
Booknews
Neurosurgeon Heifetz, author of The right to die, describes the principles of an ethic that can justify sound medical decisions within the confines of uncertainty. Not only for physicians and nurses, but also for patients and their families, as well as for policy makers. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780879757212
  • Publisher: Prometheus Books
  • Publication date: 7/28/1992
  • Pages: 1
  • Product dimensions: 1.00 (w) x 1.00 (h) x 1.00 (d)

Table of Contents

Introduction 9
Acknowledgments 15
1 A Concept of Ethics 17
2 General Problems in Application 47
3 The Doctor-Patient Relationship 53
4 The Right of Self-Determination 77
5 Suicide 115
6 Abortion 133
7 The Tragic Newborn 153
8 Euthanasia 169
9 Human Experimentation 183
10 The Ethics of Medical Triage: Allocation and Rationing of Health Care 207
Summary 223
App. A: Discussion of Mastery 225
App. B: Discussion of Privacy 229
App. C: Example of Durable Power of Attorney 235
App. D: Recommendations Regarding Fetal Research 237
App. E: The Belmont Report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 243
Index 261
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