: From its founding in 1847, the AMA divided drugs into "ethical" and "unethical" preparations. Those that were ethical had a known composition and were advertised only to the profession. Others, patent medicines (technically proprietary drugs, whose trademarks were protected by copyright), were sold directly to the public. In spite of the AMA's efforts to ban the advertising and sale of these nostrums, proprietary drugs flourished during the nineteenth century. Starting in 1900, however, three major societal trends combined to bolster (...) the AMA's campaign, and by 1920 almost all advertising was directed to physicians, who would then prescribe medications to their patients. This ban on advertising pharmaceuticals directly to the public remained virtually unchanged until approximately 1980. Since then, it has slowly eroded and, as recently as 1997, the FDA created guidelines for pharmaceutical companies to advertise on television. What does this change say about the profession of medicine, the role of the physician in society, and the doctor-patient relationship? Using a comparative historical approach, this paper examines these issues. (shrink)
How do engineers respond to ethical dilemmas that occur in practice? How do they view their individual and collective responsibilities? How do they make decisions before all the facts are in? Using the space shuttle programme as the framework, this book examines the role of ethical decision making in the practice of engineering. In particular, the book considers the design and development of the main engines of the space shuttle as a paradigm for how individual engineers perceive, articulate, and resolve (...) ethical dilemmas in a large, complex organisation. A series of in-depth case studies show engineers at work on various stages of the project as they balance budgets, deadlines and risks. By documenting the historical development of a single system, the book provides a unique opportunity to explore the complex interactions between political, organisational and technical pressures and engineering and management decisions. (shrink)
This paper describes the first three-year experience of the Consortium Ethics Program (CEP-1) of the University of Pittsburgh Center for Medical Ethics, and also outlines plans for the second three-year phase (CEP-2) of this experiment in continuing ethics education. In existence since 1990, the CEP has the primary goal of creating a cost-effective, permanent ethics resource network, by utilizing the educational resources of a university bioethics center and the practical expertise of a regional hospital council. The CEP's conception and specific (...) components stem from recognition of the need to make each hospital a major focus of educational efforts, and to provide academic support for the in-house activities of the representatives from each institution. (shrink)
Long-established stereotypes tend to dominate the perceptions physicians have of the philosophers and other humanists who serve as medical ethicists. They also alter the views humanists have of physicians, and those that the public have of both. These stereotypes are a formidable barrier to effective working relationships between the two groups of professionals, as well as to public understanding of medical ethics issues. To achieve a better working relationships and to foster more realistic understanding, it is important that the humanists (...) step out of their academic settings, for a time, and become part of the clinical service. (shrink)
Philosophers have long recognized that the unique values of the individual physician effect medical-ethical decision-making. While not taking issue with this basic assumption, this article critically examines one discussion of how different philosophies (existential, utilitarian, and value realist) can influence a neurosurgeon's decision to operate upon a person having a malignant brain tumor. It also delineates and discusses a fund of ‘medical wisdom’ commonly available to any neurosurgeon and easily obtainable by both researcher and patient. The article suggests that those (...) in the humanities interested in studying the ethical decision-making process in a medical subspecialty become familiar with this fund of knowledge. It can provide a base for evaluating when and how individual medical decisions vary. In this specific instance, the medical knowledge base was used to direct attention to when and how ethical issues are identified and resolved within the staff clinical neurosurgical setting. An informal survey among resident and staff neurosurgeons supported the conclusion that philosophical analyses of medical-ethical decision-making are appreciated when case examples are carefully and accurately documented, when medical terminology is used correctly and when recognition of the practical limits placed on medical decision-making is given. CiteULike Connotea Del.icio.us What's this? (shrink)