Ethical Problems in Emergency Medicine: A Discussion-based Review

by John Jesus (Editor), Peter Rosen (Editor), James Adams (Editor), Arthur R. Derse (Editor), Shamai Grossman (Editor)

Overview

This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short discussion of the case, as if at a morbidity and mortality conference, by a panel of experienced attending physicians explaining how they would approach the ethical dilemmas associated with the case, and a review of the existing literature.

Product Details

ISBN-13:	9781118292129
Publisher:	Wiley
Publication date:	06/13/2012
Series:	Current Topics in Emergency Medicine
Sold by:	JOHN WILEY & SONS
Format:	eBook
Pages:	352
File size:	2 MB

About the Author

John Jesus, MD, Chief Resident, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Clinical Instructor, Department of Emergency Medicine, Christiana Care Health System, Newark, DE, USA.

Peter Rosen, MD, FACS, FACEP, Director of Education, Beth Israel Deaconess Medical Center; Senior Lecturer in Medicine, Harvard Medical School, Boston, MA, USA.

Shamai A. Grossman, MD, MS, FACEP, Vice Chair for Resource Utilization; Director, Cardiac Emergency Center, Division of Emergency Medicine, Beth Israel Deaconess Medical Center; Assistant Professor of Medicine, Harvard Medical School, Boston, MA, USA.

Arthur R. Derse, MD, JD, FACEP, Director, Center for Bioethics and Medical Humanities, Julia and David Uihlein Professor of Medical Humanities; Professor of Bioethics and Emergency Medicine, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.

James G. Adams, MD, Professor and Chair, Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, Chicago, IL, USA.

Richard Wolfe, MD, Chief of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor of Medicine, Harvard Medical School, Boston, MA, USA.

Table of Contents

Contributors, ix

Preface, xiii

Section One: Challenging professionalism

1 Physician care of family, friends, or colleagues, 3
Taku Taira, Joel Martin Geiderman

2 The impaired physician, 15
Peter Moffett, Christopher Kang

3 Disclosure of medical error and truth telling, 27
Abhi Mehrotra, Cherri Hobgood

4 Conflicts between patient requests and physician obligations, 37
Shellie L. Asher

5 Judgmental attitudes and opinions in the emergency department, 47
V. Ramana Feeser

6 Using physicians as agents of the state, 57
Jeremy R. Simon

Section Two: End-of-life decisions

7 Family-witnessed resuscitation in the emergency department: making sense of ethical and practical considerations in an emotional debate, 69
Kirsten G. Engel, Arthur R. Derse

8 Palliative care in the emergency department, 79
Tammie E. Quest, Paul DeSandre

9 Refusal of life-saving therapy, 89
Catherine A. Marco, Arthur R. Derse

10 Revisiting comfort-directed therapies: death and dying in the emergency department, including withholding and withdrawal of life-sustaining treatment, 99
Raquel M. Schears, Terri A. Schmidt

11 Futility in emergency medicine, 117
Arthur R. Derse

Section Three: Representing vulnerable populations

12 The care of minors in the emergency department, 129
Chloë-Maryse Baxter

13 Chemical restraints, physical restraints, and other demonstrations of force, 139
Michael P. Wilson, Christian M. Sloane

14 Capacity determination in the patient with altered mental status, 149
Michael C. Tricoci, Catherine A. Marco

15 Obstetric emergency: perimortem cesarean section, 15
Kenneth D. Marshall, Carrie Tibbles

Section Four: Outside influence and observation

16 Non-medical observers in the emergency department, 169
Joel Martin Geiderman

17 Religious perspectives on do-not-resuscitate (DNR) documents and the dying patient, 179
Avraham Steinberg

18 Non-physician influence on the scope and responsibilities of emergency physicians, 187
Laura G. Burke, Jennifer V. Pope

19 Privacy and confidentiality: particular challenges in the emergency department, 197
Jessica H. Stevens, Michael N. Cocchi

Section Five: Emergency medicine outside the emergency department

20 Short-term international medical initiatives, 209
Matthew B. Allen, Christine Dyott, John Jesus

21 Disaster triage, 221
Matthew B. Allen, John Jesus

22 The emergency physician as a bystander outside the hospital, 237
Zev Wiener, Shamai A. Grossman

23 Military objectives versus patient interests, 247
Kenneth D. Marshall, Kathryn L. Hall-Boyer

Section Six: Public health as emergency medicine

24 Treatment of potential organ donors, 261
Glen E. Michael, John Jesus

25 Mandatory and permissive reporting laws: conflicts in patient confidentiality, autonomy, and the duty to report, 271
Joel Martin Geiderman

26 Ethics of care during a pandemic, 287
John C. Moskop

Section Seven: Education and research

27 Practicing medical procedures on the newly or nearly dead, 301
Ajay V. Jetley, Catherine A. Marco

28 Ethics of research without informed consent, 311
Dave W. Lu, Jonathan Burstein, John Jesus

Appendix: useful resources, 321
Alexander Bracey

Index, 325

Editorial Reviews

This outstanding work immediately becomes the standard textbook for ethics in emergency medicine, as the best competing text (Ethics in Emergency Medicine, 2nd edition, Iserson et al. (Galen Press, 1995)) is relatively out of date. It is a crucial resource for all emergency professionals and anyone with an interest in emergency medicine ethics. ”  (Doody’s, 30 August 2013)

From the Publisher

Reviewer: Griffin Trotter, MD, PhD (Saint Louis University)
Description: This book employs actual cases, with dialogue and commentary from experienced emergency professionals, to explore a wide range of ethical problems occurring in emergency medicine.
Purpose: It seeks "to consolidate the relevant literature" in emergency ethics, present the thoughts of practicing emergency physicians, and provide "a practical and accessible reference" for emergency professionals and students. In meeting these objectives, the book fills a crucial void.
Audience: The audience is emergency physicians, emergency medical technicians, nurses, residents, and students. However, due to the unique nature of emergency medicine and its attendant ethical problems, the book will be of interest to anyone seeking a broad understanding of the context for medical ethics. The authors are recognized, practical authorities.
Features: Each chapter begins with a case discussion that highlights diverse and sometimes antagonistic views, followed by a literature review and recommendations. The authors are commendably tolerant of dissent, refraining from awkward attempts at consensus. Another key virtue of the book is that it covers an array of underappreciated ethical problems (e.g., mandatory and permissive reporting laws and conflicting loyalties in military medicine), problems that are particularly germane to emergency medicine (e.g., disaster triage and practicing procedures on the newly dead), and familiar problems that present in unique ways in emergency medicine. Nevertheless, the necessary brevity results in some truncation - for instance, the chapter on "The Ethics of Care During a Pandemic," which omits crucial literature pertaining to assisted ventilation and the various ethical rationales for limiting liberty during a pandemic.
Assessment: This outstanding work immediately becomes the standard textbook for ethics in emergency medicine, as the best competing text (Ethics in Emergency Medicine, 2nd edition, Iserson et al. (Galen Press, 1995)) is relatively out of date. It is a crucial resource for all emergency professionals and anyone with an interest in emergency medicine ethics.

Doody's Review Service