Search results for 'Medical ethics Decision making' (try it on Scholar)

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  1.  14
    Decision Making (2012). S Hared Decision Making is Widely Accepted as an Ethical Imperative1–5 and as an Important Part of Reasoned Clinical Practice. 6 Major Texts in Decision Analysis, 7 Medical Ethics, 8 and Evidence-Based Medicine9 All Encourage Physicians to Include Patients in the Decision-Making Process. [REVIEW] In Stephen Holland (ed.), Arguing About Bioethics. Routledge 346.
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  2. Douglas N. Walton (1985). Physician-Patient Decision-Making: A Study in Medical Ethics. Greenwood Press.
     
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  3.  58
    Y. J. Craig (1996). Patient Decision-Making: Medical Ethics and Mediation. Journal of Medical Ethics 22 (3):164-167.
    A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of (...)
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  4.  11
    Benjamin Moulton & Jaime S. King (2010). Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice. Journal of Law, Medicine & Ethics 38 (1):85-97.
    Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: create model (...)
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  5.  12
    J. de Boer, G. van Blijderveen, G. van Dijk, H. J. Duivenvoorden & M. Williams (2012). Implementing Structured, Multiprofessional Medical Ethical Decision-Making in a Neonatal Intensive Care Unit. Journal of Medical Ethics 38 (10):596-601.
    Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. (...)
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  6. Judith Andre (1998). Ethics and Medical Decision-Making. Society for Medical Decision-Making Newsletter (53):6-8.
     
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  7. Erica K. Salter (2015). The Re-Contextualization of the Patient: What Home Health Care Can Teach Us About Medical Decision-Making. HEC Forum 27 (2):143-156.
    This article examines the role of context in the development and deployment of standards of medical decision-making. First, it demonstrates that bioethics, and our dominant standards of medical decision-making, developed out of a specific historical and philosophical environment that prioritized technology over the person, standardization over particularity, individuality over relationship and rationality over other forms of knowing. These forces de-contextualize the patient and encourage decision-making that conforms to the unnatural and contrived environment (...)
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  8.  17
    Thomas May (2004). Social Restrictions on Informed Consent: Research Ethics and Medical Decision Making. HEC Forum 16 (1):38-44.
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  9.  9
    Georg Spielthenner (2008). The Principle of Double Effect as a Guide for Medical Decision-Making. Medicine, Health Care and Philosophy 11 (4):465-473.
    Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For these reasons, (...)
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  10.  17
    Katherine Hall (2002). Medical Decision-Making: An Argument for Narrative and Metaphor. Theoretical Medicine and Bioethics 23 (1):55-73.
    This study examines the processes ofdecision-making used by intensive care(critical care) specialists. Ninety-ninespecialists completed a questionnaire involvingthree clinical cases, using a novel methodologyinvestigating the role of uncertainty andtemporal-related factors, and exploring a rangeof ethical issues. Validation and triangulationof the results was done via a comparison studywith a medically lay, but highly informed groupof 37 law students. For both study groups,constructing reasons for a decision was largelyan interpretative and imaginative exercise thatwent beyond the data (as presented), commonlyresulting in different (...)
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  11.  8
    Tom Koch & Mark Ridgley (1999). Consensus in Medical Decision Making: Analyzing the Environment of Discourse Ethics. Philosophy and Geography 2 (2):201 – 217.
    In recent years geographic interest has focused increasingly on the moral and ethical dimensions of social constructions. Much of this work has followed the direction taken by moral philosophers whose principled approach has been applied to a range of ethically or morally problematic contexts. The challenge has been to apply a geographic perspective to an ethical dilemma that seems intractable at the level of ethical principle. This paper uses a geographic perspective to consider in a concrete fashion a current bioethical (...)
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  12. Bryan Jennett (1988). Medical Ethics and Economics in Clinical Decision Making. In Gavin H. Mooney & Alistair McGuire (eds.), Medical Ethics and Economics in Health Care. Oxford University Press 90--102.
     
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  13. Alan Schwartz (2008). Medical Decision Making: A Physician's Guide. Cambridge University Press.
    Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the (...)
     
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  14.  4
    Heidi Albisser Schleger, Nicole R. Oehninger & Stella Reiter-Theil (2011). Avoiding Bias in Medical Ethical Decision-Making. Lessons to Be Learnt From Psychology Research. Medicine, Health Care and Philosophy 14 (2):155-162.
    When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or (...)
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  15.  1
    Benjamin Moulton & Jaime S. King (2010). Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice. Journal of Law, Medicine and Ethics 38 (1):85-97.
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  16.  3
    Tom Koch & Mark Ridgley (1999). Consensus in Medical Decision Making: Analyzing the Environment of Discourse Ethics. Ethics, Place and Environment 2 (2):201-217.
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  17.  4
    Ellen Painter Dollar (2004). Ethics Journal of the American Medical Association February 2004, Volume 6, Number 2 Clinical Case 3 Finding the Balance in Shared Decision Making. [REVIEW] Ethics 6 (2):3.
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  18.  5
    Silviya Aleksandrova (2008). Survey on the Experience in Ethical Decision-Making and Attitude of Pleven University Hospital Physicians Towards Ethics Consultation. Medicine, Health Care and Philosophy 11 (1):35-42.
    BackgroundContemporary medical practice is complicated by many dilemmas requiring ethical sensitivity and moral reasoning.ObjectiveTo investigate physicians’ experience in ethical decision-making and their attitude towards ethics consultation.MethodsIn a cross-sectional survey 126 physicians representing the main clinics of Pleven University hospital were investigated by a self-administered questionnaire. The following variables were measured: occurrence, nature and ways of resolving ethical problems; physicians’ attitudes towards ethics consultation; physicians’ opinions on qualities and skills of an ethics consultant, and socio-demographic (...)
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  19.  5
    Malene Tanderup, Sunita Reddy, Tulsi Patel & Birgitte Bruun Nielsen (2015). Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India. Journal of Bioethical Inquiry 12 (3):491-501.
    As a neo-liberal economy, India has become one of the new health tourism destinations, with commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. (...)
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  20. Robert M. Veatch (2010). Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases. Oxford University Press.
    A model for ethical problem solving -- Values in health and illness -- What is the source of moral judgments? -- Benefiting the patient and others : duty to do good and avoid harm -- Justice : allocation of health resources -- Autonomy -- Veracity : honesty with patients -- Fidelity : promise-keeping, loyalty to patients, and impaired professionals -- Avoidance of killing -- Abortion, sterilization, and contraception -- Genetics, birth, and the biological revolution -- Mental health and behavior control (...)
     
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  21.  6
    Georges Hélal (1988). Physician-Patient Decision-Making: A Study in Medical Ethics Douglas N. Walton Contributions in Philosophy, Vol. 27 New York, NY: Greenwood Press, 1985. Xv, 265 P. $35.00. [REVIEW] Dialogue 27 (1):163.
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  22.  1
    G. Bruce (2002). Ethics, Management and Mythology: Rational DecisionMaking for Health Service Professionals (Michael Loughlin, Radcliffe Medical Press, Oxford, £24.95, ISBN 1–85775–574–X). [REVIEW] Journal of Evaluation in Clinical Practice 8 (2):287-290.
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  23. Barry Hoffmaster (1986). Douglas N. Walton, Physician-Patient Decision Making: A Study in Medical Ethics Reviewed By. Philosophy in Review 6 (8):407-409.
     
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  24. Hans-Martin Sass (2000). Ethical Decision Making in Commitee: The Role of Review Boards and Ethics Commitees in Healt Care, Health Policy and Medical Research. Convivium 13:148-165.
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  25. Ronald E. Cranford & A. Edward Doudera (eds.) (1984). Institutional Ethics Committees and Health Care Decision Making. Health Administration Press.
     
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  26. C. Gordon Scorer & Antony John Wing (eds.) (1979). Decision Making in Medicine: The Practice of its Ethics. E. Arnold.
     
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  27.  9
    Alan G. Johnson (2006). Making Sense of Medical Ethics: A Hands-on Guide. Distributed in the U.S.A. By Oxford University Press.
    The practice of clinical medicine is inextricably linked with the need for moral values and ethical principles. The study of medical ethics is, therefore, rightly assuming an increasingly significant place in undergraduate and postgraduate medical courses and in allied health curricula. Making Sense of Medical Ethics offers a no-nonsense introduction to the principles of medical ethics, as applied to the everyday care of patients, the development of novel therapies and the undertaking of (...)
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  28.  11
    Thomas May (2002). Bioethics in a Liberal Society: The Political Framework of Bioethics Decision Making. Johns Hopkins University Press.
    Issues concerning patients' rights are at the center of bioethics, but the political basis for these rights has rarely been examined. In Bioethics in a Liberal Society: The Political Framework of Bioethics Decision Making , Thomas May offers a compelling analysis of how the political context of liberal constitutional democracy shapes the rights and obligations of both patients and health care professionals. May focuses on how a key feature of liberal society -- namely, an individual's right to make (...)
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  29.  45
    L. -C. Huang, C. -H. Chen, H. -L. Liu, H. -Y. Lee, N. -H. Peng, T. -M. Wang & Y. -C. Chang (2013). The Attitudes of Neonatal Professionals Towards End-of-Life Decision-Making for Dying Infants in Taiwan. Journal of Medical Ethics 39 (6):382-386.
    The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with (...)
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  30.  20
    David J. Rothman (2003). Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making. Aldinetransaction.
    Introduction: making the invisible visible -- The nobility of the material -- Research at war -- The guilded age of research -- The doctor as whistle-blower -- New rules for the laboratory -- Bedside ethics -- The doctor as stranger -- Life through death -- Commissioning ethics -- No one to trust -- New rules for the bedside -- Epilogue: The price of success.
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  31.  5
    Subrata Chattopadhyay & Alfred Simon (2008). East Meets West: Cross-Cultural Perspective in End-of-Life Decision Making From Indian and German Viewpoints. [REVIEW] Medicine, Health Care and Philosophy 11 (2):165-174.
    Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address (...)
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  32. Robert M. Veatch, Amy M. Haddad & Dan C. English (2009). Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases. Oxford University Press Usa.
    We are living in an unprecedented era of biomedical revolution. Medicine is remaking humans, and controversy surrounds such topics as abortion, artificial organs, brain circuitry, eugenics, euthanasia, and gene therapy. At the same time, medical advances are posing complex ethical problems for both patients and professionals. The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases explores fundamental ethical questions arising from real situations faced by health professionals, patients, (...)
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  33.  29
    Mark Coeckelbergh & Jessica Mesman (2007). With Hope and Imagination: Imaginative Moral Decision-Making in Neonatal Intensive Care Units. [REVIEW] Ethical Theory and Moral Practice 10 (1):3 - 21.
    Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature, points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research, we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination aids medical practitioners (...)
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  34.  39
    Erica K. Rangel (2009). Clinical Ethics and the Dynamics of Group Decision-Making: Applying the Psychological Data to Decisions Made by Ethics Committees. [REVIEW] HEC Forum 21 (2):207-228.
    Clinical Ethics and the Dynamics of Group Decision-Making: Applying the Psychological Data to Decisions Made by Ethics Committees Content Type Journal Article Pages 207-228 DOI 10.1007/s10730-009-9096-7 Authors Erica K. Rangel, Saint Louis University Department of Health Care Ethics 6333 North Rosebury Ave #3W St. Louis MO 63105 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 2.
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  35.  4
    Madelyn Anne Iris (1995). The Ethics of Decision Making for the Critically Ill Elderly. Cambridge Quarterly of Healthcare Ethics 4 (2):135.
    The ethics of decision making for the critically ill elderly is an area of concern for all those involved in the decision-making process. The number of participants involved in decision making around end-of-life issues may be many: treatment and care decisions often bring together not only the patient and the physician, but the family, an extended medical care team, and impartial members of a hospital or institutional ethics committee. In addition, treatment (...)
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  36. John Mark Freeman (1987). Tough Decisions: A Casebook in Medical Ethics. Oxford University Press.
    Tough Decisions presents many of the complex medical-ethical issues likely to confront practitioners in critical situations. Through fictional but true-to-life cases, vividly described in clinical terms, the authors force the reader to choose among different courses of action and to confront a range of possible consequences. A two-year-old has been diagnosed with a malignant brain tumor. Who should be allowed to make decisions about the child's surgery and subsequent therapy, and on what basis? A family history of Huntington's disease (...)
     
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  37.  19
    Claudia Wild (2005). Ethics of Resource Allocation: Instruments for Rational Decision Making in Support of a Sustainable Health Care. Poiesis and Praxis 3 (4):296-309.
    Objective: In all western countries health care budgets are under considerable constraint and therefore a reflection process has started on how to gain the most health benefit for the population within limited resource boundaries. The field of ethics of resource allocation has evolved only recently in order to bring some objectivity and rationality in the discussion. In this article it is argued that priority setting is the prerequisite of ethical resource allocation and that for purposes of operationalization, instruments such (...)
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  38.  48
    C. Hammerman, O. Lavie, E. Kornbluth, J. Rabinson, M. S. Schimmel & A. I. Eidelman (1998). Does Pregnancy Affect Medical Ethical Decision Making? Journal of Medical Ethics 24 (6):409-413.
    OBJECTIVE: We studied and compared the attitudes of pregnant women v new mothers in an attempt to confirm changing patterns of maternal response towards medical ethical decision making in critically ill or malformed neonates. DESIGN: Data were obtained by questionnaires divided into three sections: 1. sociodemographic; 2. Theoretical principles which might be utilised in the decision-making process; 3. Hypothetical case scenarios, each followed by possible treatment options. RESULTS: Pregnant women (n = 545) consistently requested less (...)
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  39.  21
    Jeremy Snyder, Valorie A. Crooks, Rory Johnston & Shafik Dharamsi (2013). “Do Your Homework…and Then Hope for the Best”: The Challenges That Medical Tourism Poses to Canadian Family Physicians' Support of Patients' Informed Decision-Making. [REVIEW] BMC Medical Ethics 14 (1):37.
    Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism.
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  40.  7
    E. Angell, A. J. Sutton, K. Windridge & M. Dixon-Woods (2006). Consistency in Decision Making by Research Ethics Committees: A Controlled Comparison. Journal of Medical Ethics 32 (11):662-664.
    There has been longstanding interest in the consistency of decisions made by research ethics committees in the UK, but most of the evidence has come from single studies submitted to multiple committees. A systematic comparison was carried out of the decisions made on 18 purposively selected applications, each of which was reviewed independently by three different RECs in a single strategic health authority. Decisions on 11 applications were consistent, but disparities were found among RECs on decisions on seven applications. (...)
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  41.  9
    C. Breitsameter (2010). Medical Decision-Making and Communication of Risks: An Ethical Perspective. Journal of Medical Ethics 36 (6):349-352.
    The medical decision-making process is currently in flux. Decisions are no longer made entirely at the physician's discretion: patients are becoming more and more involved in the process. There is a great deal of discussion about the ideal of ‘informed consent’, that is that diagnostic and therapeutic decisions should be made based on an interaction between physician and patient. This means that patients are informed about the advantages and disadvantages of a treatment as well as alternatives to (...)
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  42.  8
    M. Jonas (2007). The Baby MB Case: Medical Decision Making in the Context of Uncertain Infant Suffering. Journal of Medical Ethics 33 (9):541-544.
    The recent MB case involved a dispute between an infant’s parents and his medical team about the appropriateness of continued life support. The dispute reflected uncertainty about two key factors that inform medical decision making for seriously ill infants: both the amount of pain MB experiences and the extent of his cognitive capacities are uncertain. Uncertainty of this order makes decision making in accordance with the best-interests principle very problematic. This article addresses two of (...)
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  43.  43
    O. C. Ferrell (2013). Business Ethics: Ethical Decision Making and Cases. Houghton Mifflin Co.
    Providing a vibrant four-color design, market-leading BUSINESS ETHICS: ETHICAL DECISION MAKING AND CASES, Ninth Edition, thoroughly covers the complex environment in which managers confront ethical decision making. Using a proven managerial framework, this accessible, applied text addresses the overall concepts, processes, and best practices associated with successful business ethics programs--helping readers see how ethics can be integrated into key strategic business decisions. Thoroughly revised, the new ninth edition incorporates coverage of new legislation affecting (...)
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  44.  43
    Baruch A. Brody (1988). Life and Death Decision Making. Oxford University Press.
    Integrating theory with case studies, this book examines the practical application of moral theory in clinical decision-making through 40 composite cases based on actual clinical experience. Complex, realistic, and challenging, these examples contain the multiplicity of factors faced in clinical crises, making this a superb exploration of the ways in which theory relates to actual life-or-death situations.
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  45.  4
    G. S. Chung, R. E. Lawrence, F. A. Curlin, V. Arora & D. O. Meltzer (2012). Predictors of Hospitalised Patients' Preferences for Physician-Directed Medical Decision-Making. Journal of Medical Ethics 38 (2):77-82.
    Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer (...)
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  46.  10
    B. Elango, Karen Paul, Sumit K. Kundu & Shishir K. Paudel (2010). Organizational Ethics, Individual Ethics, and Ethical Intentions in International Decision-Making. Journal of Business Ethics 97 (4):543 - 561.
    This study explores the impact of both individual ethics (IE) and organizational ethics (OE) on ethical intention (EI). Ethical intention, or the individual's intention to engage in ethical behavior, is useful as a dependent variable because it relates to behavior which can be an expression of values, but also is influenced by organizational and societal variables. The focus is on EI in international business decision-making, since the international context provides great latitude in making ethical decisions. (...)
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  47.  14
    Zhanna Bagdasarov, Chase E. Thiel, James F. Johnson, Shane Connelly, Lauren N. Harkrider, Lynn D. Devenport & Michael D. Mumford (2013). Case-Based Ethics Instruction: The Influence of Contextual and Individual Factors in Case Content on Ethical Decision-Making. Science and Engineering Ethics 19 (3):1305-1322.
    Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases (...)
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  48.  12
    Chris Provis (2010). Virtuous Decision Making for Business Ethics. Journal of Business Ethics 91 (1):3 - 16.
    In recent years, increasing attention has been given to virtue ethics in business. Aristotle's thought is often seen as the basis of the virtue ethics tradition. For Aristotle, the idea of phronësis, or 'practical wisdom', lies at the foundation of ethics. Confucian ethics has notable similarities to Aristotelian virtue ethics, and may embody some similar ideas of practical wisdom. This article considers how ideas of moral judgment in these traditions are consistent with modern ideas about (...)
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  49.  20
    Jessica Richmond Moeller, Teresa H. Albanese, Kimberly Garchar, Julie M. Aultman, Steven Radwany & Dean Frate (2012). Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults. [REVIEW] HEC Forum 24 (2):99-114.
    Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another (...)
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  50.  14
    Brian W. Kulik (2009). More Than Lip Service: The Development and Implementation Plan of an Ethics Decision-Making Framework for an Integrated Undergraduate Business Curriculum. [REVIEW] Journal of Academic Ethics 7 (4):231-254.
    In the face of the business community’s widening concern about corporate ethical behavior, business schools are reexamining how they ensure that students appreciate the ethical implications of managerial decision making and have the analytical tools necessary to confront ethical dilemmas. The current approaches adopted by colleges vary from mere ‘lip service’ to embedding ethics at the core of the curriculum. This paper examines the experience of several US universities that have incorporated business ethics into their curricula. (...)
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