Although the notion of physician value neutrality in medicine may be traced back to the writings of Sir William Osler, it is relatively new to medicine and medical ethics. We argue in this paper that how physician value neutrality has been cashed out is often obscure and its defense not persuasive. In addition, we argue that the social/political implementation of neutrality, Political Liberalism, fails, and thus, PVN's case is weakened, for PVN's justification relies largely on the reasoning undergirding PL. For (...) these reasons, we conclude that PVN has no philosophical or ethical warrant and thus should be abandoned. We suggest that the physician present to her patients some type of statement or creed that would give them an idea of where she stands on important axiological issues and how these stands are cashed out clinically. (shrink)

Christian physicians are in danger of losing the right of conscientious objection in situations they deem immoral. The erosion of this right is bolstered by the doctrine of "physician value neutrality" (PVN) which may be an impetus for the push to require physicians to refer for procedures they find immoral. It is only a small step from referral to compelling performance of these same procedures. If no one particular value is more morally correct than any other (a foundational PVN premise) (...) and a physician ought to be value neutral, than conscientious objection to morally objectionable actions becomes a thing of the past. However, the argument for PVN fails. Therefore, Christian physicians should state their values openly, which would allow patients the ability to choose like-minded physicians. Some possible responses to this erosion of conscientious objection include, disengagement from non-Christian institutions, the formation of distinctly Christian medical institutions and political action. However, for the Christian the initial focus should be on a life of holiness which requires each of us to avoid evil. (shrink)

H. Tristram Engelhardt, Jr., Joseph Boyle, John Peppin, David Solomon; Christian Bioethics, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Vol.

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Conflicting Interests in MedicineLaura Jean Bierut, Sal Cruz-Flores, Laura E. Hodges, Anthony A. Mikulec, Govind K. Nagaldinne, Erine L. Bakanas, John F. Peppin, Joel S. Perlmutter, William H. Seitz Jr., Edward Diao, Andre N. Sofair, and David M. Zientek• To Recruit or Not to Recruit for a Clinical Trial• An Unexpected Lesson• Am I on call for the entire Midwest?• Why is Medicare Wasting Away?• The Downside of (...) the Informed Consent Juggernaut• Expert Testimony at the Food and Drug Administration: Who Wants the Truth?• Crossroads: The Intersection of Personal, Professional Society, and Industry Relationships• A Change of Heart• The Evolution of Conflicts of Interest in a New Subspecialty: A Case Study of the Development of Interventional CardiologyCopyright © 2011 The Johns Hopkins University Press... (shrink)

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Physician conflict of interest has been of concern since Hippocrates and rarely is this concern more evident than in the relationship between pharmaceutical sales representatives (PSR) and physicians. Given the acrimonious public debates concerning this issue a careful exploration of the concerns at sake and the conceptual arguments which support such concerns is called for. In this piece I will take as heuristic the conceptual philosophical framework argued for by H. Tristram Engelhardt. This framework would sanction interactions between PSRs and (...) physicians given that such relationships are free and without coercion. Further, patients must be informed, uncoerced and free in choosing such relationships with physicians who engage in interactions with PSRs. I consider four major criticisms which claim that PSR-physician interactions are morally impermissible: 1) influence, 2) “patients do not choose, but they pay,” 3) violation of ethical principles, and 4) erosion of the patient-physician relationship. Each is shown to be unpersuasive under Engelhardtian philosophy. As long as the principle of permission and informed consent obtain without coercion than the interaction between PSRs and physicians would be construed to be morally permissible. (shrink)

Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient (...) relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it. (shrink)

Since their appearance in 1850, Pharmaceutical Sales Representatives (PSR) interactions with physicians have engendered intense emotional responses. The controversy has continued unabated since that time. Arguments in favor of the moral impermissibility of the PSR-physician relationship can be divided into four general categories; (1) influence, (2) patients pay but they do not choose, (3) violation of principlism, and (4) the erosion of the patient-physician relationship. None of the arguments that have thus far been proposed against the moral permissibility of these (...) interactions gives sufficient warrant to avoid them (or pursue them). It may be the case that PSR-physician interactions place the patientphysician relationship in jeopardy. This would constitute enough warrant, from a pragmatic perspective, to shun such relationships. However, no research supports this contention. A careful evaluation of the literature leaves one ambivalent at best. Keywords: pharmaceutical sales representatives, influence, conflict of interest CiteULike Connotea Del.icio.us What's this? (shrink)

Since osteopathic medicine's inception its distinction has been proclaimed steadfastly in the osteopathic literature. The uniqueness has been claimed to reside in: (1) rigid adherence to A.T. Still's tenets; (2) osteopathic manipulative treatment (OMT); (3) claims of “holism”; (4) “osteopathic principles”, (5) esoteric definitions; and (6) other suggested differences. None of these claims can be successfully defended. An aspect of the osteopathic distinction may lie in the didactic of OMTper se. Certain experiences in medical school contribute to the “reconstruction” of (...) the student's view of the patient. Touch, through OMT, may be a quality that affects this change and helps make the osteopathic physician different. When blended with traditional medical modalities thismay result in a unique medical perspective. The ideal approach for the osteopathic profession would be an honest evaluation of its function in society and its uniqueness in medicine. The profession may discover a uniqueness withtouch as an integral part. (shrink)