Textbook of Healthcare Ethics

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics ( ) offering healthcare workers and students a new perspective on ethical.
Table of contents

• Ethics & the Law
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As a non Catholic Christian I found the point of view very useful. I read the book prior to the class and then again with the class and found more in it each time I read it.

I used this book for an online Ethics course; I think it should be used only in a classroom setting. I did not care for the questions or the case study at the end of the chapter. Many times, both were to be answered by opinion only. I think the questions should relate more to information within the text that can be answered. Again, this book should be used in a classroom setting, not for an online course. However, I would not recommend this book for either setting. See all 4 reviews. Customers who viewed this item also viewed. Textbook of Healthcare Ethics. Pages with related products.

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Amazon Drive Cloud storage from Amazon. Alexa Actionable Analytics for the Web. AmazonGlobal Ship Orders Internationally. Amazon Inspire Digital Educational Resources. Amazon Rapids Fun stories for kids on the go. How do you handle conflicting opinions among family members over an elderly patient's competence? See The case of Mr Golubchuk for an example. Confidentiality forms a cornerstone of the doctor-patient relationship; it implies respecting the patient's privacy, encouraging them to seek care and preventing discrimination on the basis of their medical condition.

To maintain trust between doctor and patient, the physician cannot release personal medical information without the patient's consent. Like other ethical duties, however, confidentiality is not absolute.

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It may be necessary to override privacy in the interests of public health, as in contact tracing for partners of a patient with a sexually transmitted disease; you are legally obliged to report a possibly HIV infected patient to the public health authorities. However, this should always be done in a way that minimizes harm to the patient. A patient's relative gives you information on the patient but asks you not to reveal where the information came from. Do you have to keep this secret?

For the patient to be well informed and to make informed choices i. This would include, for example, information on medical errors made in their care.

As the American College of Physicians says: A teenage patient requests an abortion but asks you not to tell her parents. How do you balance protection of the patient's confidentiality against the rights of her parents? There are some circumstances under which you may choose not to disclose information to a patient, including when the patient specifically asks not to be told you should still offer them the chance to know the truth ; when a patient is incapacitated here you typically inform the family ; during an emergency when the patient's condition is unstable and immediate care is required; and the controversial notion of 'therapeutic privilege', which means that the doctor deems that the risk of informing the patient is worse than not doing so e.

Link to Disclosing adverse events. Informed Consent follows from the principle of patient autonomy, and consent is required before you may provide care. Informed consent also serves as a significant protection to you against possible litigation. That said, much of what you do is on the basis of implied consent. If a patient makes an appointment to see you and volunteers a history, answers your questions and submits without objection to a medical examination, you may safely infer that consent for the examination was implied.

Consent may be expressed or implied ; the former e. Consent may be given verbally, but a consent form provides evidence of consent. It is not a contract, however, and the patient can withdraw consent at any time. The patient must have the mental competence to comprehend the information, and must give specific authorization for the doctor to proceed with the plan.

The onus is not exclusively on the doctor: Consent forms that the patient typically signs in a hospital are chiefly for information, and will not necessarily protect the doctor from litigation. Patients commonly do not remember the contents of the consent form. Laura Weiss Roberts has written on this topic, and the following diagram is adapted from her articles:. First, be aware of a distinction between ethical arguments that are based on set principles "lying is always morally wrong", or "our religion forbids it" , which is called principlism and more flexible arguments in which the circumstances of a case influence the decision.

This is called casuistry , or case-based argument. Here, theory plays a lesser role, and judgments are reached by referring to paradigms or 'pure cases' that illustrate accepted appropriate ways of acting. This is also how the law works, and you may see a parallel with the difference between deductive and inductive reasoning. Our approach to medical ethics is evolving and is influenced by many currents of thought. Codes of ethics can aspire to be general universal , or particular. In a culturally diverse country such as Canada, this distinction is significant as minority groups may not accept the mainstream approach, and seek to adopt a particular code.

Medical ethics and law: Edinburgh, Churchill Livingstone, The Best Interests of the Patient. This seems to be central to medicine: But how do you decide what is in their best interest? This is often loosely defined in terms of well being, but this does not help very much. Your judgment of 'best interests' may consider the patient's expressed wishes and the factors they would consider if they were able to do so ; any written express wishes of the patient living will, etc ; family members or others priest, When a patient is incapacitated coma, dementia, etc it may be especially problematic to decide what is in his or her best interest.

An obligation to take care to prevent harm occurring to another person. Doctors generally owe a duty of care to their patients, as does the hospital that employs the doctor. Outside of her office or hospital, a doctor does not normally owe a duty of care, unless she stops and represents herself as a doctor by word or deed. She is then legally liable for any care she provides.

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Doctors are not legally required to act as Good Samaritans, but moral duty generally suggests that they will respond to the call "'Is there a doctor in the house? A duty of care issue always arises in treating dangerous diseases; a recent article reviews health care workers' duty of care in virulent epidemics. To prove negligence requires that the plaintiff establish that the doctor owed a duty of care; that the care provided was below the appropriate standard, and that this caused the patient harm.

Negligence is usually defined in reference to the standard of an ordinary person exercising the skill in question e. A physician is not obligated to provide services such as abortion, sterilization, contraception that conflict with their personal moral standards. But they do have a duty to inform the patient about options or refer them for such treatments, so that the patient's rights and autonomy are not compromised. Withdrawing or Withholding Treatment. These are equally justifiable in the law; treatments should not be withheld out of a fear that they cannot be subsequently withdrawn once commenced.

For example, it is acceptable to undertake a time-limited trial of a treatment in a terminally ill patient to clarify prognosis. The topics of easing the dying process, avoiding needless pain and suffering, and avoiding unwanted treatments often lead to discussion over the distinction between assistance in the dying process and assisting suicide. In euthanasia, the physician directly and intentionally administers a substance to cause death.

Different constituencies have made differing laws concerning physician-assisted suicide. For example, the American College does not support its legalization, while Oregon does allow physician-assisted suicide. In Canada it was formerly illegal to assist a person in committing suicide even though suicide itself is not illegal , but iIn February , the Supreme Court of Canada struck down the constitutional ban on physician-assisted suicide.

Details on the Palliative care page. Advance planning allows a competent person to express their preferences for future care, especially should they cease to be competent to make decisions.

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It allows their values and preferences to be considered, and generally identifies a surrogate decision-maker. All patients should be encouraged to undertake such discussions with their family members; documentation about their preferences should be included in their medical record. The discussion should cover topics such as do-not-resuscitate orders, as such topics cannot be undertaken under crisis circumstances such as a cardiopulmonary arrest.



Sometimes family members desperately wish to have 'everything possible' done to save their relative. Are there circumstances where a doctor could write a DNR order for a terminally ill patient against the family's wishes? Power of Attorney transfers decision-making authority to a designated person. American College of Physicians. Ethics Manual fifth edition. Textbook of Healthcare Ethics by Erich E. Ships from and sold by Amazon. Customers who viewed this item also viewed. Page 1 of 1 Start over Page 1 of 1. Ethics of Health Care: Sponsored products related to this item What's this?

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Get effective tools in your arsenal to beat procrastination, get more done and claim your life back! Springer; 2nd edition July 20, Language: Be the first to review this item Amazon Best Sellers Rank: Related Video Shorts 0 Upload your video. Customer reviews There are no customer reviews yet. Share your thoughts with other customers. Write a customer review. Amazon Giveaway allows you to run promotional giveaways in order to create buzz, reward your audience, and attract new followers and customers.