Ethics In Clinical Practice / Edition 2

Ethics In Clinical Practice / Edition 2

by Judith Ahronheim, Jonathan Moreno, Connie Zuckerman
     
 

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ISBN-10: 0763729450

ISBN-13: 9780763729455

Pub. Date: 07/11/2004

Publisher: Jones & Bartlett Learning

Ethics in Clinical Practice, Second Edition continues to focus on multidisciplinary medicine and how ethical dilemmas affect not only doctors and patients, but also nurses, social workers, members of ethics committees, hospital attorneys, administrators, and others. Greater attention is given to care in a variety of settings and across settings. Cases reflect the

Overview

Ethics in Clinical Practice, Second Edition continues to focus on multidisciplinary medicine and how ethical dilemmas affect not only doctors and patients, but also nurses, social workers, members of ethics committees, hospital attorneys, administrators, and others. Greater attention is given to care in a variety of settings and across settings. Cases reflect the managed care phenomenon and cost containment, demographic changes, the electronic revolution, and the ethical dilemmas resulting from this new climate. The revised edition discusses advances in palliative medicine and its availability, and includes new data regarding attitudes and prevalence of physician-assisted suicide. Attention is given to how issues of cost containment might directly or indirectly influence patients' end-of-life treatment options. Cases are updated to include pertinent information about medical advances and legal developments, and how ethical analysis reflects these new developments.

Product Details

ISBN-13:
9780763729455
Publisher:
Jones & Bartlett Learning
Publication date:
07/11/2004
Edition description:
2E
Pages:
508
Product dimensions:
6.00(w) x 8.90(h) x 1.10(d)

Table of Contents

Prefacexi
Acknowledgmentsxiii
Chapter 1About Clinical Ethics1
Defining Clinical Ethics1
The New Clinical Ethics3
The Emergence of Modern Clinical Ethics4
Who Practices Clinical Ethics?6
Religion in Clinical Ethics7
Cultural Competence and Clinical Ethics9
Law in Clinical Ethics9
Public Policy and Clinical Ethics12
Organization Ethics and Clinical Ethics13
Chapter 2A Theory of Clinical Ethics17
The Dominant Moral Philosophies in Clinical Ethics: Deontology and Utilitarianism17
The Principles: Self-Determination, Beneficence, and Justice18
Chapter 3Evaluating Common Distinctions51
Active and Passive51
Ordinary and Extraordinary Means52
Killing and Letting Die53
Withholding and Withdrawing54
Chapter 4Clinical Ethics throughout the Life Span57
Before Pregnancy57
During Pregnancy60
Infants63
Children and Adolescents66
The Elderly68
Treating the Family70
Futility72
Brain Death and Organ Procurement74
Chapter 5Assessing the Standard Theory79
A Critique of the Standard Theory79
Casuistry82
The Care Perspective84
Feminist Ethics86
Chapter 6Strategy for a Clinical Ethics Assessment91
The Organizational Climate91
Identifying the Ethical Issues92
Common Pitfalls in Assessing Decisional Capacity93
Common Types of Ethical Conflict94
A Protocol for a Clinical Ethics Intervention97
Chapter 7Cases99
Case 1A Religious Objection to a Blood Transfusion99
Issues To Consider100
Medical Considerations100
Ethical and Legal Considerations103
Case 2Determining If a Patient Has Decisional Capacity109
Issues To Consider110
Medical Considerations110
Ethical and Legal Considerations113
Case 3Urgent Surgery in a Stuporous Patient: The Use and Limitations of Advance Directives121
Issues To Consider121
Medical Considerations121
Ethical and Legal Considerations123
Case 4Management of Life-Threatening Illness: An Intensive Care Unit Patient with Uncertain Decisional Capacity131
Issues To Consider133
Medical Considerations133
Ethical and Legal Considerations134
Case 5"Don't Tell Mother": Withholding Information from a Patient144
Issues To Consider145
Medical Considerations145
Ethical and Legal Considerations146
Case 6Alternative Medicine for a Patient with Advanced Cancer152
Issues To Consider153
Medical Considerations153
Ethical and Legal Considerations158
Case 7Painful Treatment for a Severely Retarded Man168
Issues To Consider168
Medical Considerations168
Ethical and Legal Considerations171
Case 8Withdrawing Mechanical Ventilation at the Request of a Patient with Decisional Capacity180
Issues To Consider180
Medical Considerations180
Ethical and Legal Considerations182
Case 9Withholding Tube Feeding in a Woman with Advanced Dementia188
Issues To Consider188
Medical Considerations189
Ethical and Legal Considerations194
Case 10A Religious Objection to the Determination of Brain Death203
Issues To Consider203
Medical Considerations203
Ethical and Legal Considerations207
Case 11A Teenager with Prolonged Unconsciousness215
Issues To Consider215
Medical Considerations216
Ethical and Legal Considerations221
Case 12Resuscitation Decision in a Patient with Lung Cancer228
Issues To Consider229
Medical Considerations229
Ethical and Legal Considerations230
Case 13Dispute over DNR Status in a Patient Who Wants Palliative Surgery241
Issues To Consider242
Medical Considerations242
Ethical and Legal Considerations245
Case 14Suicide Risk in a Managed Care Patient252
Issues To Consider253
Medical Considerations253
Ethical and Legal Considerations256
Case 15Assisted Suicide in a Man with Amyotrophic Lateral Sclerosis267
Issues To Consider268
Medical Considerations268
Ethical and Legal Considerations277
Case 16A Married Man Contracts Syphilis287
Issues To Consider287
Medical Considerations287
Ethical and Legal Considerations290
Case 17A House-Bound Woman with Tuberculosis297
Issues To Consider297
Medical Considerations297
Ethical and Legal Considerations301
Case 18Surgical Delay in a Patient Infected with HIV311
Issues To Consider311
Medical Considerations311
Ethical and Legal Considerations315
Case 19An Elderly Driver323
Issues To Consider323
Medical Considerations323
Ethical and Legal Considerations326
Case 20A Difficult Patient and the Limits of Provider Obligations334
Issues To Consider335
Medical Considerations335
Ethical and Legal Considerations337
Case 21"Do Everything": Physician Obligations in the Face of Family Demands346
Issues To Consider347
Medical Considerations347
Ethical and Legal Considerations350
Case 22A Man with Alcoholic Cirrhosis Wants a Liver Transplant358
Issues To Consider358
Medical Considerations359
Ethical and Legal Considerations361
Case 23Genetic Testing in a Woman with a Family History of Breast Cancer368
Issues To Consider368
Medical Considerations368
Ethical and Legal Considerations372
Case 24Assisted Reproduction in a Woman with Strong Religious Beliefs382
Issues To Consider384
Medical Considerations384
Ethical and Legal Considerations390
Case 25Prenatal Counseling of a Pregnant Woman at Risk for HIV Infection399
Issues To Consider399
Medical Considerations399
Ethical and Legal Considerations404
Case 26A Pregnant Woman Using Cocaine413
Issues To Consider413
Medical Considerations413
Ethical and Legal Considerations416
Case 27Tracheoesophageal Fistula in a Newborn with Down Syndrome425
Issues To Consider425
Medical Considerations425
Ethical and Legal Considerations430
Case 28Determination of Death in a Newborn441
Issues To Consider441
Medical Considerations442
Ethical and Legal Considerations445
Case 29A Religious Objection to a Child's Medical Treatment453
Issues To Consider453
Medical Considerations453
Ethical and Legal Considerations455
Case 30A Teenager Who Wants Cosmetic Surgery463
Issues To Consider463
Medical Considerations464
Ethical and Legal Considerations466
Case 31An Adolescent with Cancer Who Wants to Discontinue Medical Treatment474
Issues To Consider475
Medical Considerations475
Ethical and Legal Considerations476
Appendix AInternet References, Suggested Readings, and Other Sources483
Index493

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