Tag: medical ethics

Blog Posts (22)

June 23, 2014

Two Doctors, Two Generations: Q&A with Dr. Barron Lerner

On May 6, 2014, Barron Lerner, MD, PhD, kicked off the Lerner Lectureship series with a talk that explored the evolution of medical ethics through the lens of his father's and his own practice of medicine. Dr. Lerner's father, Phillip I. Lerner, MD, was "a revered clinician, teacher and researcher who always put his patients […]
August 28, 2013

How Future Doctors Think

How Future Doctors Think
Flanigan Lecture Explores How Medical Students Make Sense of Their World

 What kind of physician do you want? Do you want someone who, out of respect for your autonomy, explains treatment options but makes no recommendations, leaving the decision up to you? Or do you want something more?

If you want something more, the research conducted by Felicia Cohn, Ph.D., who presented the 19th Annual Rosemary Flanigan Lecture on July 30, 2013, underscores the importance of knowing how your doctor thinks and helping him or her to understand your story.

Patterns in Their Stories

When Dr. Cohn taught medical ethics at the University of California-Irvine School of Medicine, she noticed patterns in the stories medical students shared concerning conflicts they encountered between their personal values and professional obligations and what they did about them. Her colleague at UCI, Humanities Director Johanna Shapiro, wondered if there might be a way to analyze and identify themes from these stories as told in 299 papers Dr. Cohn had collected.

“The themes of the students’ narratives really did fall quite neatly into six categories,” said Dr. Cohn.

• Restitution (38%)  - Appealed to a moral norm or ethical principle.
• Compromise (16%) – Conceded core values.
• Journey (16%) – Grew through experience.
• Witnessing (13%) – Felt empathy but stood by and watched.
• Resistance (9%) – Rejected professional ethics in favor of personal views
• No Problem (2%) – Never experienced any conflict.

“I thought the papers would tell a lot more stories about witnessing and compromise, which were the type of stories that the students mostly shared in class,” said Dr. Cohn. “But it turned out that restitution – appeal to principle – was the most common story they told. And more often than not the principle the students appealed to was autonomy. In other words, it’s okay for me to do this because it’s what the patient said he wants.”

Autonomy or Guidance?

Dr. Cohn explained that this emphasis on autonomy in modern medical culture has important implications for both healthcare professionals and their patients.

“If physicians really think what a patient is doing is wrong but feel that respecting autonomy takes precedence, they’re going to be spending a lot of time doing things that they think are wrong. Then they’re miserable and we go and ask them to be nice to patients. I can’t help but think that’s where a lot of the dissatisfaction and even burnout from healthcare professionals comes from.”

Conversely, for the patient who wants more than options from their physician – who wants their physician to consider how their illness and treatment will integrate into their life and make honest recommendations based on that – then the doctor who tells a restitution story probably isn’t the doctor for them.

Learn more at http://www.PracticalBioethics.org
December 18, 2012

Medical Interpreters and Patient Communications

Medical interpreters help patients, doctors communicate Kirsti Marohn and Stephanie Dickrell USA Today December 9, 2012Health care regulations require medical providers who receive federal funding to provide interpreters. There's al...
November 27, 2012

The Social Construction of Cancer - Part 3

Editor's Note: This is the third of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU’s department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport. Part III In a later visit with the homecare teams, I met Rajesh - a 29-year-old man who has been battling cancer since his […]
November 14, 2012

The Social Construction of Cancer - Part 2

Editor’s Note: This is the second of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU's department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport. Part II However, at this point, Shambu and Rohini's story took a sharp turn. The palliative care team I was visiting with discovered that, […]
November 2, 2012

The Social Constructions of Cancer

Editor’s Note: This is the first of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU’s department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport. Introduction The contemporary landscape of healthcare in Delhi inspires very little confidence. The lack of public insurance, scarcity of resources and rising cost of […]
March 15, 2012

The March Issue of AJOB is Now Online

The American Journal of Bioethics is proud to announce that its March issue, a special issue discussing issues related to lying in medicine, is now available online.…

January 12, 2011

Move Over Dr. House--Fox is Developing a REAL Medical Ethics TV Show

According to Playbill.com, the writer and executive producer of such shows as HBO’s “In Treatment” and network TV’s “Law & Order: Criminal Intent” Warren Leight is developing a new medical show that is focused exclusively on medical ethics.…

July 21, 2010

A Code of Silence

We all know that there is honor among thieves, but apparently a similar code exists among physicians, both good and bad.…

May 14, 2010

Becoming a Doctor--By Video Game?

Apothecary Healers vs. Lords of Pestilence in the land of Soma? No, it’s not something you missed from Brave New World or a bad knock off of Lord of the Rings.…

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Published Articles (39)

American Journal of Bioethics: Volume 11 Issue 6 - Jun 2011

Fat Chance Getting an Obstetrician in South Florida? Ethics and Discrimination in Obstetrics and Gynecology

American Journal of Bioethics: Volume 11 Issue 2 - Feb 2011

Book Review of D. Micah Hester, End of Life Care and Pragmatic Decision Making

American Journal of Bioethics: Volume 10 Issue 11 - Nov 2010

Pain Treatment Agreements

American Journal of Bioethics: Volume 10 Issue 9 - Sep 2010

To the Barricades!

American Journal of Bioethics: Volume 10 Issue 5 - May 2010

Response to Open Peer Commentaries on ?Stem Cell Tourism and the Power of Hope?

American Journal of Bioethics: Volume 10 Issue 5 - May 2010

Stem Cell Tourism and the Power of Hope

American Journal of Bioethics: Volume 10 Issue 1 - Jan 2010

Response to Open Peer Commentaries on ?The Pitfalls of Deducing Ethics from Economics: Why the Association of American Medical Colleges is Wrong About Pharmaceutical Detailing?

American Journal of Bioethics: Volume 10 Issue 1 - Jan 2010

The Pitfalls of Deducing Ethics From Behavioral Economics: Why the Association of American Medical Colleges Is Wrong About Pharmaceutical Detailing

American Journal of Bioethics: Volume 10 Issue 3 - Mar 2010

The Secret of Caring for Mr. Golubchuk

American Journal of Bioethics: Volume 10 Issue 3 - Mar 2010

The Case of Samuel Golubchuk and the Right to Live

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News (51)

October 23, 2012 6:44 pm

Reproductive Tourism: Paying Women in Poor Countries to Bear Our Babies is Rife with Ethical Problems (HealthCanal.com)

In their upcoming paper, “Ethical concerns for maternal surrogacy and reproductive tourism” in theJournal of Medical Ethics, Professor Raywat Deonandan et al. enumerate the specific ethical challenges posed by this emerging new industry.  Along with six other concerning issues, the authors identified the tension between business ethics and medical ethics as being at the heart of the industry’s ethical problem, along with an insufficiently broad definition of “informed consent.” When desperately poor, illiterate and vulnerable village women are entering into complicated contracts to sell their reproductive health to wealthy foreigners, often some of the softer social risks are not communicated to them, such as their risk of estrangement from their communities, or the risk of domestic unease with their spouses and existing children.

August 28, 2012 12:45 pm

Doctors Refuses To Treat 200-Pound Woman Because Of Her Weight (Business Insider)

In an interview with WCVB-TV, Dr. Carter explained, “After three consecutive injuries (with other patients) trying to care for people over 250 pounds, my office is unable to accommodate a certain weight and we put a limit on it.”
And Carter is completely within her professional rights to do so. Under Opinion 9.12 of the AMA Code of Medical Ethics, both physicians and patients are free to decline a relationship. “A physician may decline to undertake the care of a patient whose medical condition is not within the physician’s current competence,” the code says.

August 15, 2012 1:35 pm

Autism Transplant Denial Sparks Debate (ABC News)

Dr. David Cronin, an associate professor of transplant surgery at the Medical College of Wisconsin, told ABCNews.com he does not know the case, but organ transplant denial tends to be easier for people to accept because of an anatomic problem, such as calcified blood vessels that would prevent the successful implantation of a new kidney.

August 14, 2012 7:51 pm

Doctors Fail to Review Tests Before Hospital Discharge (Businessweek)

Doctors who order tests for hospital patients don’t always read the results before the patient is discharged, raising the risk of missing potentially dangerous conditions, an Australian study found.  About half of the unread tests were ordered on the day the patient left the hospital, according to research today in the Archives of Internal Medicine. Many of those results still hadn’t been reviewed two months later, the researchers said.

August 12, 2012 6:39 pm

More voices raising questions about consumer gene testing (Silicon Beat)

The Mercury News editorial page had a great column today from three experts on genetic testing that provides the medical perspective on why a physician should be involved in the direct-to-consumer genetic testing process. They argue that these are indeed medical tests, despite industry arguments otherwise. And the results are complex.

August 6, 2012 7:46 pm

Organ Transplant Scandal Shocks Germany (Democratic Underground)

A surgeon identified as Dr. Aiman O. is suspected of fraudulently manipulating dozens of his patients’ test results, making them appear sicker than they were to get them liver transplants more quickly — and possibly putting them ahead of people who more desperately needed them. The case first emerged in late July at the University Medical Center Göttingen, in the northern German state of Lower Saxony, from where the senior physician has been suspended since November for allegedly tampering with some 23 transplant cases. A gastroenterologist suspected of involvement has also been suspended.

July 26, 2012 4:20 pm

Circumcision for Non-Medical Reasons Is Wrong (Spiegel Online)

As the debate over the medical ethics of circumcision rages in Germany, some have argued that the practice provides health benefits. But many in the medical community disagree. Circumcision is not in the best interest of boys who undergo the procedure.

July 17, 2012 4:08 pm

Penn expert addresses ethical implications of testing for Alzheimer's disease risk (Eureka Alert)

VANCOUVER – Diagnostic tests are increasingly capable of identifying plaques and tangles present in Alzheimer’s disease, yet the disease remains untreatable. Questions remain about how these tests can be used in research studies examining potential interventions to treat and prevent Alzheimer’s disease. Experts from the Perelman School of Medicine at the University of Pennsylvania will today participate in a panel at the Alzheimer’s Association International Conference 2012 (AAIC 2012) discussing ways to ethically disclose and provide information about test results to asymptomatic older adults.  In contrast to diseases like cancer – where tumor progression and genetic markers can be measured to determine appropriate preventative steps or targeted treatments – Alzheimer’s disease tests has improved diagnosis and assessment of risk, but no treatments or preventative measures are available to alter the disease progression.

 

July 13, 2012 1:09 pm

Turkish doctors face fines for elective caesareans (The Guardian)

Itil is concerned that doctors might not be ready to opt for surgery once the law is in place: “How can a law decide when a patient requires a certain treatment? This is against medical ethics, and the art of medicine in general. Turkey will set a very negative example with this law.”

July 12, 2012 12:35 pm

Patients reluctant to disagree with doctor's advice (Chicago Tribune)

NEW YORK (Reuters Health) – Although most people who participated in a new survey preferred making medical decisions together with their doctor, the majority said they wouldn’t speak up if what they wanted conflicted with their physician’s recommendations.

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