Medical Ethics Resource Guide

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Most of us realize that practicing medicine is not just about memorizing the human anatomy and prescribing pharmaceuticals.  In order to be a competent physician, one must understand how to act in a medically ethical manner.

The following resource guide provides links to information about issues in medical ethics including patient confidentiality, informed consent, cultural/religious considerations, conflicts of interest, and issues in medical research. The guide also contains book recommendations for further reading.

Quick Facts – Confidentiality – Informed Consent – Cultural Considerations
Religious Considerations – Conflicts of Interest – Medical Research Ethics –Other Topics – Book Resources
 

Quick Facts

  • All “individually identifiable health information” from patients is legally protected under confidentiality rules. (U.S. Health and Human Services)
  • Informed consent protocol requires physicians to initiate a learning and communication process with his or her patient. (AMA)
  • Certain minority communities may have high rates of dissatisfaction in health care treatment due to cultural differences between patients and providers. (JGIM)
  • One out of five primary care doctors who have worked in religious health care institutions has experienced ethical conflict over faith-oriented medical protocols. (Amednews)
  • Physician attitudes towards pharmaceutical and medical device company promotional gifts tends to vary across medical practice specialty. (Businessweek)
  • Basic medical research standards recommend that researchers protect not only human health, but also animal and environmental health to some extent. (NIH)

 

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Confidentiality

  • AMA: Patient Confidentiality: This website provides a general overview of ethical and legal requirements regarding patient-physician confidentiality.  The article also discusses exceptions to confidentiality and general suggestions for how to maintain confidentiality.
  • Center for Health Ethics: Confidentiality: This resource from the University of Missouri School of Medicine discusses issues of confidentiality in modern medical settings.  Information includes a discussion of electronic records and confidentiality involving minors.
  • Confidentiality: Ethical Topic in Medicine: This website, through the University of Washington School of Medicine, provides an overview of patient confidentiality duties for physicians.  The site also provides examples of exception cases.
  • Electronic Records, Patient Confidentiality, and the Impact of HIPAA: This article discusses medical confidentiality challenges as records are converted to electronic files.  The article also gives a historical overview of efforts to protect patient confidentiality.
  • Summary of the HIPAA Privacy Rule: Here the U.S. Department of Health and Human Services provides an expandable list of information about the Health Insurance Portability and Accountability Act of 1996.  Among other regulations, the act created confidentiality protocols that healthcare providers must follow.

 

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Informed Consent

  • AMA: Informed Consent: This webpage outlines what informed consent means in the medical context.  The information also discusses how medical providers can protect themselves from legal repercussions related to informed consent issues.
  • American Cancer Society: Informed Consent: This page provides examples for what informed consent means from a patient’s point of view.  Health care providers can benefit by looking through these specific steps that ensure informed consent is achieved.
  • Exceptions to Informed Consent in Emergency Medicine: This article provides a legal analysis of the cases that constitute an exception to informed consent protocols.  The report cites several patient situations and court precedents.
  • Informed Consent: Ethical Topic in Medicine: This webpage from the University of Washington School of Medicine discusses the basics of informed consent.  Content includes a comprehensive description of what informed consent encompasses and exceptions to the rule.
  • Informed Consent, Parental Permission, and Assent in Pediatric Practice: This paper from the American Academy of Pediatrics, describes the issue of informed consent as applicable to minors.  The report is a helpful resource for any healthcare professional working with children.

 

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Cultural Considerations

 

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Religious Considerations

 

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Conflicts of Interest

 

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Medical Research Ethics

  • Distinguishing Dilemmas in the Ethics of Placebo-Controlled Trials: This article discusses the question of whether or not placebo-controlled trials can be considered ethical.  The analysis includes consideration of the researcher’s ability to remain impartial to which patients are assigned to each trial type.
  • Ethical Issues in Clinical Research: This short article contains a general overview of conducting medically ethical research.  It contains links to fundamental documents in this ethical field.
  • The Ethics of Clinical Research: This resource examines the purpose of clinical research in comparison with ethical obligations as a researcher.  Though the approach is theoretical, every health researcher should consider the points of this article.
  • The Ethics of Human Embryonic Stem Cell Research: This article is an overview of the moral issues surrounding human stem cell research.  This is a good initial resource for individuals who would eventually like to explore the topic more deeply.
  • The Ethics of Medical Research on Children: This article brings a human face to the discussion of ethics in medical research.  The case history presents a unique dilemma in considering the limits of research on human subjects.
  • Regulations and Ethical Guidelines: This website maintained by the National Institutes of Health contains the text from the World Medical Association Declaration of Helsinki.  The declaration sets the ethical standards for research across the world.

 

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Other Topics

  • BBC Ethics Guide: Euthanasia: This website is entirely devoted to the subject of physician-assisted suicide.  Resources include an explanation of euthanasia and reasons behind it, as well as legislation related to the practice.
  • Do Not Resuscitate Orders: Ethical Topic in Medicine: This website is a great resource for health care practitioners to understand the controversies surrounding Do-Not-Resuscitate orders.  The article offers practical advice on how to handle situations where a Do-Not-Resuscitate order is involved.
  • Ethical Issues in Genetic Testing for BRCA2 and BRCA2: This webpage is a source of information about how to handle the controversies surrounding genetic testing for cancer risk.  The site contains an interactive module where practitioners can evaluate a hypothetical case.
  • The Ethics of Genetic Testing: This resources covers the ethical issue of genetic testing in general.  The discussion includes both patient decisions and consideration of insurance implications.
  • ‘Octo-mom’ Straddles the Line in Reproduction Debate: In this website, a reporter reviews the main points of controversy over in vitro fertilization.  The procedure presents an ethical dilemma on several levels.
  • Project to Get Transplant Organs From ER Patients Raises Ethics Questions: This article discusses the pros and cons of policies which aim to increase organ transplantation rates.  The reporter examines the central question of when a physician should stop trying to resuscitate a patient and begin instead to consider organ transplantation.
  • Psychiatrists’ Attitudes Toward Involuntary Hospitalization: This article discusses the controversial subject of involuntary psychiatric hospital commitment.  The study illustrates that physicians and the general public tend to have differing views on which populations should be involuntarily committed, but agreed that individuals who pose a risk to themselves or others should be committed for treatment.
  • Public Health Ethics: This article discusses medical ethics as applicable to public health.  Topics include disease reporting and preventative health measures.
  • Termination of Life-Sustaining Treatment: Ethical Topic in Medicine: Separate from the issues of euthanasia, this article discusses the appropriate conditions for terminating treatment.  Several hypothetical conditions are considered.
  • Truth-telling and Withholding Information: Ethical Topic in Medicine: This resource discusses the question of whether it can ever be ethical to withhold information from a patient about his or her illness.  Though disclosure may be difficult at times, in almost all cases physicians have the obligation to disclose.

 

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Book Resources

  • Classic Works in Medical Ethics: Core Philosophical Readings by Gregory Pence: This collection of readings provides a background in the important issues of medial ethics.  It serves as a good resource for anyone interested in the history of medical ethics as well as current controversies.
  • Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians by Philip C. Hébert: From this resource individuals entering the medical professions should learn how to create an ethical medical practice.  The book combines theory and practical advice.
  • Law and Ethics for Medical Careers by Karen Judson and Carlene Harrison: This book is an overall resource for health care practitioners interested in the legal ramification of medical decisions.  The reader will learn about relevant legal cases and legislation as well as anecdotal scenarios.
  • Medical Ethics: A Very Short Introduction by Tony Hope: This short book is a general introduction to some of the key controversies in health care.  This is a good initial resource for those interested in researching biomedical ethics.
  • Medical Ethics: Accounts of the Cases that Shaped and Define Medical Ethics by Gregory Pence: This book is a good overview of several issues in medical ethics.  Discussion includes medical research ethics as well as patient treatment considerations.
  • Principles of Biomedical Ethics by Tom L. Beauchamp and James F. Childress: This resource provides an encompassing perspective on moral issues in medicine.  The book moves from an examination of moral norms themselves to specific issues in the biomedical realm.
  • Tough Decisions: Cases in Medical Ethics by John M. Freeman M.D. and Kevin McDonnell M.D.: This book is a great resource for health care providers who would like to consider medical ethics issues in a practical manner.  The approach is interactive and forces the reader to actually make decisions on a number of ethical scenarios.

 

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