Blog Posts (39)
April 29, 2014
<p>Earlier this month, the New York Times (NYT) reported on individuals in a minimally conscious state (MCS). Although the article headed: ‘<a href="http://www.nytimes.com/2014/04/16/health/pet-scans-found-to-clarify-vegetative-state.html">PET Scans offer clues on Vegetative States</a>’, its contents addressed the technologies around MCS: a ‘<a href="https://www.neurology.org/content/58/3/349.full">newly</a>’ diagnosed state of consciousness. The paper commented that PET scans would be more beneficial than functional Magnetic Resonance Imaging (functional M.R.I.) in diagnosing this state. Around the same time, the NYT published a paper that headed: ‘<a href="http://www.nytimes.com/2014/04/18/business/treatment-cost-could-influence-doctors-advice.html">Cost of treatment may influence doctors</a>’. This paper quoted a doc saying: “There should be forces in society who should be concerned about the budget, about how many M.R.I.s we do, but they shouldn’t be functioning simultaneously as doctors,”</p>
<p>In this blog post I want to focus on the cost and price of consciousness. I do not only want to focus on the economic costs, but also on costs in a more holistic sense, including the psychological and emotional costs. In the end, I want to ask you: how much is consciousness worth to you?</p>
<p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.bvg</strong></p>
March 2, 2014
<p class="MsoNormal">If someone asked me: What is my philosophy of clinical ethics? I would initially be dumbstruck for an answer. In response, I would probably try to define an answer from my background in bioethics and philosophy. I would pick frameworks in philosophy that represent my approach. For example, I would be inclined to refer to pragmatism and casuistry, as frameworks that determine my clinical ethics approach. <a href="/BioethicsBlog/post.cfm/a-brain-dead-woman-and-her-fetus-calculating-rights-and-wrongs">My last blogpost</a> about Marlise Munoz, the brain dead woman in Texas is a good example of this. My philosophy as a clinical ethicist is based on the facts of the case, a subsequent calculation of rights and wrongs. The outcome of this sum guides my ethics advice about what is practically possible, conform short-handed <a href="http://plato.stanford.edu/entries/pragmatism/">pragmatism</a>. In responding to a case, I start with the specifics of a case and formulate answers that may be acceptable by multiple stakeholders, instead of relying on general theoretical outcomes, as a short-handed <a href="http://plato.stanford.edu/entries/theory-bioethics/#StrParCas">casuist</a>. Finally, I reason along the lines of several relevant principles, such as autonomy, beneficence, non-maleficence, justice and dignity, and seek to apply these principles to the specifics of a case.</p>
<p class="MsoNormal">However, given that the background of clinical ethicists lies over a broad spectrum, I doubt that this answer would be satisfactory. If I hadn’t had a background in bioethics, what would I have answered to this question? Does the fact that I am an ethicist in the clinic mean that I have to frame my answers along philosophical and ethical theories? Would a social worker, an accountant or an attorney equally have a philosophy in their work? Asking myself this latter question, I think that those professions do have a professional philosophy, but that they would be less likely to phrase it in philosophical language. Instead, probably they would describe their philosophy in more layman’s terms and would narrate about their approach in the different cases they see. So how do I approach my cases as a clinical ethicist?</p>
<p class="MsoNormal"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
February 12, 2014
by Kayhan Parsi, JD, PhD
I recently saw a subspecialist for a medical procedure. I had never met this physician before so as he sat down to review what was going on in the monitor in front of him, the first thing he asked me was what I did for a living. …
September 16, 2013
by Maurice Bernstein MD
Informed consent is the ethical and legal hallmark for the support of patient decision-making in medicine. Though the ethics of patient communication of facts without deceit has been part of medical consideration for generations, it wasn’t until the landmark decision Schloendorff v The Society of the New York Hospital in 1914 that informed consent became United States law. …
July 15, 2013
ATTENTION: HEALTH CARE ETHICS CONSULTANTS
The American Society for Bioethics and Humanities (ASBH) would like your input.
Please take part in this short (8 question) survey to determine whether you endorse the FINAL DRAFT of the Code of Ethics for Health Care Ethics Consultants:
(Paste link in browser if survey doesn’t load by clicking on it.)
It should take about 10-15 minutes to complete.…
April 2, 2013
Maurice Bernstein, M.D.
Here is a realistic scenario as written in the U.S. government’s Agency for Healthcare Research and Quality “Web M&M” website which could occur in any teaching or even in non-teaching hospital with hospitalists on duty.…
February 17, 2013
The February 2013 issue of Clinical Kidney Journal has a case report from Israel describing a 101-year-old male patient with chronic kidney disease, admitted to the ICU with exacerbation of heart failure and sepsis. He experienced acute deteriorat...
February 14, 2013
Craig Klugman, Ph.D.
Every fall, I teach 30 medical and nursing students observation skills in our institution’s Art Rounds course. My colleagues and I take these students to one of our local museums where they learn how to observe their environment and patients by looking at works of art, learning about the role of observation in medicine, and by observing real life models.…