Assesses the ethical problems that doctors face every day and advocates a more universal code of medical ethics, one that draws on the traditions of religion and philosophy.

The 2018 Varsity Medical Ethics debate convened upon the motion: “This house believes that the constant monitoring of our health does more harm than good”. This annual debate between students from the Universities of Oxford and Cambridge is now in its tenth year. This year’s debate was hosted at the Oxford Union on 8th of February 2018, with Oxford winning for the Opposition, and was the catalyst for the collation and expansion of ideas in this paper.New technological devices (...) have the potential to enhance patient autonomy, improve patient safety, simplify the management of chronic diseases, increase connectivity between patients and healthcare professionals and assist individuals to make lifestyle changes to improve their health. However, these are pitted against an encroachment of technology medicalising the individual and home, an exacerbation of health inequalities, a risk to the security of patient data, an alteration of the doctor-patient relationship dynamic and an infringement on individual self-identity. This paper will draw upon and develop these concepts, while contending arguments for and against constant health monitoring. This is not a review of medical devices and health monitoring, but a reflective development and more detailed elaboration of the main points highlighted in the 2018 Varsity Medical Ethics debate. (shrink)

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were (...) 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country. (shrink)

Muslim Medical Ethics draws on the work of historians, health-care professionals, theologians, and social scientists to produce an interdisciplinary view of ...

A collection of readings on topics such as abortion, organ transplantation, and HIV. Valuable for practitioners, and students of medical ethics.

This book is intended as a practical introduction to the ethical problems which doctors and other health professionals can expect to encounter in their practice. It is divided into three parts: ethical foundations, clinical ethics, and medicine and society. The authors incorporate new chapters on topics such as theories of medical ethics, cultural aspects of medicine, genetic dilemmas, aging, dementia and mortality, research ethics, justice and health care (including an examination of resource allocation), and medicine, (...) class='Hi'>ethics and medical law. Medical Ethics also covers issues having to do with the beginning and end of life, as well as ethical questions surrounding the human body and the use of human tissue, confidentiality and AIDS, care of the mentally ill, and the implications of genetic technology. Each chapter presents a range of ethical views, drawing both from traditional philosophy and the most recent contemporary trends. The theoretical discussion is extended and illustrated by case studies and examples. This book is a non-technical guide to ethics written with the needs of medical students and medical practitioners in mind. It will also appeal to students and practitioners of allied health professions, and for all users of health care services. (shrink)

Drawing on a wide range of primary historical and sociological sources and employing sharp philosophical analysis, this book investigates medical ethics from a Chinese-Western comparative perspective. In doing so, it offers a fascinating exploration of both cultural differences and commonalities exhibited by China and the West in medicine and medical ethics. The book carefully examines a number of key bioethical issues in the Chinese socio-cultural context including: attitudes toward foetuses; disclosure of information by medical professionals; (...) informed consent; professional medical ethics; health promotion; feminist bioethics; and human rights. It not only provides insights into Chinese perspectives, but also sheds light on the appropriate methods for comparative cultural and ethical studies. Through his pioneering study, Jing-Bao Nie has put forward a theory of "trans-cultural bioethics," an ethical paradigm which upholds the primacy of morality whilst resisting cultural stereotypes, and appreciating the internal plurality, richness, dynamism and openness of medical ethics in any culture. Medical Ethics in China will be of particular interest to students and academics in the fields of Medical Law, Bioethics, Medical Ethics, Cross-Cultural Ethics as well as Chinese/Asian Studies and Comparative Cross-Cultural Studies. (shrink)

This paper challenges the long-standing and widely accepted view that medical ethics is nothing more than common morality applied to clinical matters. It argues against Tom Beauchamp and James Childress’s four principles; Bernard Gert, K. Danner Clouser and Charles Culver’s ten rules; and Albert Jonsen, Mark Siegler, and William Winslade’s four topics approaches to medical ethics. First, a negative argument shows that common morality does not provide an account of medical ethics and then a (...) positive argument demonstrates why the medical profession requires its own distinctive ethics. The paper also provides a way to distinguish roles and professions and an account of the distinctive duties of medical ethics. It concludes by emphasizing ways in which the uncommon morality approach to medical ethics is markedly different from the common morality approach. (shrink)

Now in its twentieth year of publication, this rich collection, popular among teachers and students alike, provides an in-depth look at major cases that have shaped the field of medical ethics. The book presents each famous (or infamous) case using extensive historical and contextual background, and then proceeds to illuminate it by careful discussion of pertinent philosophical theories and legal and ethical issues.

There is a diversity of ‘ethical practices’ within medicine as an institutionalised profession as well as a need for ethical specialists both in practice as well as in institutionalised roles. This Brief offers a social perspective on medical ethics education. It discusses a range of concepts relevant to educational theory and thus provides a basic illumination of the subject. Recent research in the sociology of medical education and the social theory of Pierre Bourdieu are covered. In the (...) end, the themes of Bourdieuan Social Theory, socio-cultural apprenticeships and the ‘characterological turn’ in medical education are draw together the context of medical ethics education. ​. (shrink)

The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics will uphold its commitment to publishing high quality papers (...) on the full array of medical ethics. At the same time, JME aims to be a premiere home for ground-breaking scholarship on the ethical issues raised by COVID-19. Toward this end, we have a number of papers that are freely available online and for which production has been fast-tracked.1–5 A challenge for authors who want to write about the pandemic is the rapidly evolving nature of the situation and the time it takes for journal content to be reviewed and published, even when fast-tracked. For that reason, all authors who would like to submit a paper on the pandemic can also submit a post to the JME blog prior to submitting a full paper to the journal. Those interested in writing for the JME blog should contact one of its editors, Hazem Zohny or Mike King. Over the last 3 weeks, 30 high-quality commentaries on the pandemic have been posted to the blog. These posts are circulated widely via the JME Twitter and Facebook feeds and have stimulated significant …. (shrink)

A discussion of Christian ethics focuses on the physician's image as a parent, warrior against death, expert, and teacher, and the oath that guides his or her practice.

Bioethics, Volume 36, Issue 6, Page 731-732, July 2022.

We have discussed some of the activities in the field of medical ethics that have been carried out in our country within recent years.

Background Medical ethics deals with the ethical obligations of doctors to their patients, colleagues and society. The annual reports of Sri Lanka Medical Council indicate that the number of complaints against doctors has increased over the years. We aimed to assess the level of knowledge, attitude and practice regarding medical ethics among doctors in three teaching hospitals in Sri Lanka. Methods A hospital-based cross-sectional study was conducted among doctors using a pre-tested self-administered, anonymous questionnaire. Chi (...) Squared test, and ANOVA test were used to identify the significance of association between level of knowledge and selected factors. Results Most doctors had a poor level of knowledge on medical ethics, with postgraduate trainees showing significantly higher level of knowledge. The average knowledge on medical ethics among doctors was significantly different between the three hospitals. Over 95% had a favourable attitude towards gaining knowledge and advocated the need for training. The majority indicated awareness of unethical practices. 24.6% of respondents stated that they get a chaperone ‘sometimes’ during patient examination while 3.5% never do. The majority responded that they never accept gifts from pharmaceutical companies in recognition of their prescribing pattern. 12–41% of doctors participated in the study acknowledged that they ‘sometime’ engaged in unethical practices related to prescribing drugs, accepting gifts from pharmaceutical companies and when obtaining leave. Conclusion Most doctors had a poor level of knowledge of medical ethics. Postgraduate trainees had a higher level of knowledge than other doctors. The majority showed a favourable attitude towards gaining knowledge and the need of training. Regular in-service training on medical ethics for doctors would help to improve their knowledge on medical ethics, as well as attitudes and ethical conduct. (shrink)

Introduction -- Historical perspectives of medical ethics -- The medical ethics Renaissance: a brief assessment -- Risk disclosure/'informed consent' -- Consent, control and minors: Gillick and beyond -- Sterilisation/best interests: legislation intervenes -- The end of life: total abrogation -- Medical ethics in government-commissioned reports -- Conclusion.

ABSTRACTModern medical practice is becoming increasingly pluralistic and diverse. Hence, cultural competency and awareness are given more focus in physician training seminars and within medical school curricula. A renewed interest in describing the varied ethical constructs of specific populations has taken place within medical literature. This paper aims to provide an overview of Islamic Medical Ethics. Beginning with a definition of Islamic Medical Ethics, the reader will be introduced to the scope of Islamic (...) Medical Ethics literature, from that aimed at developing moral character to writings grounded in Islamic law. In the latter form, there is an attempt to derive an Islamic perspective on bioethical issues such as abortion, gender relations within the patient‐doctor relationship, end‐of‐life care and euthanasia. It is hoped that the insights gained will aid both clinicians and ethicists to better understand the Islamic paradigm of medical ethics and thereby positively affect patient care. (shrink)

A practical and thought provoking introduction to the most important ethical issues in medicine today. Over 700 entries, from short essays to brief definitions of key terms and concepts, have been contributed by leading clinicians and medical ethicists.

Issues in medical ethics are rarely out of the media and it is an area of ethics that has particular interest for the general public as well as the medical practitioner. This short and accessible introduction provides an invaluable tool with which to think about the ethical values that lie at the heart of medicine. Tony Hope deals with thorny moral questions, such as euthanasia and the morality of killing, and also explores political questions such as: (...) how should health care resources be distributed fairly? (shrink)

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

The notion of autonomy commonly employed in medical ethics literature and practices is inadequate on three fronts: it fails to properly identify nonautonomous actions and choices, it gives a false account of which features of actions and choices makes them autonomous or nonautonomous, and it provides no grounds for the moral requirement to respect autonomy. In this paper I offer a more adequate framework for how to think about autonomy, but this framework does not lend itself to the (...) kinds of practical application assumed in medical ethics. A general problem then arises: the notion of autonomy used in medical ethics is conceptually inadequate, but conceptually adequate notions of autonomy do not have the practical applications that are the central concern of medical ethics. Thus, a revision both of the view of autonomy and the practice of “respect for autonomy” are in order. (shrink)

Clinical ethics is a relatively new discipline within medicine, generated not so much by the Can we . . . ? questions of fact and prognosis that physicians ...

Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from (...) the concrete patient experiences described in healthcare literature. Dignity is conferred on people when they are treated as having equal status, something the sick and frail are often denied in healthcare settings. The importance of equal status as a unique value has been forcefully argued and widely recognised in political philosophy in the last 15 years. This paper brings medical ethics up to date with philosophical discussion about the value of equal status by developing an equal status conception of dignity. (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of (...) fee-for-service medicine to a system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation (...) model. They offer two historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

The so-called Trolley Problem was first discussed by Philippa Foot in 1967 as a way to test moral intuitions regarding the doctrine of double effect, Kantian principles and utilitarianism. Ever since, a great number of philosophers and psychologists have come up with alternative scenarios to further test intuitions and the relevance of conventional moral doctrines. Given that physicians routinely face moral decisions regarding life and death, the Trolley Problem should be considered of great importance in medical ethics. In (...) this article, five “classic” trolley scenarios are discussed: the driver diverting the trolley, a bystander pulling a lever to divert the trolley, a fat man being thrown from a bridge to stop the trolley, a bystander pulling a lever to divert a trolley so that a fat man may be run over, and a bystander pulling a lever so that a fat man falls off from a bridge to stop the trolley. As these scenarios are discussed, relevant moral differences amongst them are addressed, and some of the applications in medical ethics are discussed. The article concludes that Trolley scenarios are not the ultimate criterion to make ethical decisions in difficult ethical challenges in medicine cases but they do serve as an initial intuitive guide. (shrink)

Titel oversat: Islamisk, medicinsk etik i det tyvende århundrede.

Medical ethics, principles, persons, and perspectives is discussed under three headings: History, Theory, and Practice. Under Theory, the author will say something about some different approaches to the study and discussion of ethical issues in medicine—especially those based on principles, persons, or perspectives. Under Practice, the author will discuss how one perspectives based approach, hermeneutics, might help in relation first to everyday ethical issues and then to public controversies. In that context some possible advantages of moving from controversy (...) to conversation will be explored; and that will then be illustrated with reference to a current controversy about the use of human embryos in stem cell therapy research. The paper begins with history, and it begins in the author’s home city of Edinburgh. (shrink)

The dominant model for bioethical inquiry taught in medical schools is that of principlism. The heritage of this methodology can be traced to the Enlightenment project of generating a universalizable justification for normative morality arising from within the individual, rational agent. This project has been criticized by Alasdair MacIntyre who suggests that its failure has resulted in a fragmented and incoherent contemporary ethical framework characterized by fundamental intractability in moral debate. This incoherence implicates principlist conceptions of bioethics. Medical (...) ethics as practiced, though, is partially in keeping with teleological alternatives to principlism. Nonetheless, the hegemony of principlism threatens to harm the practice of good medicine whenever it is used to provide justification for the sanction or prohibition of practices, despite not being equipped to grant moral authority to such justifications. An example of this failure and its resulting harm is expressed in the growing obsolescence of living donor liver transplantation. (shrink)

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation, or signs of torture. Mounting information from many sources, including Pentagon documents, the International Committee of the Red Cross, Amnesty International, Human Rights Watch, etc., indicate that medical personnel failed to maintain (...) medical records, conduct routine medical examinations, provide proper care of disabled and injured detainees, accurately report illnesses and injuries, and falsified medical records and death certificates. Medical personnel and medical information was also used to design and implement psychologically and physically coercive interrogations. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. (shrink)

Medical ethics changed dramatically in the past 30 years because physicians and humanists actively engaged each other in discussions that sometimes led to confrontation and controversy, but usually have improved the quality of medical decision-making. Before then medical ethics had been isolated for almost two centuries from the larger philosophical, social, and religious controversies of the time. There was, however, an earlier period where leaders in medicine and in the humanities worked closely together and both (...) fields were richer for it. This volume begins with the 18th century Scottish Enlightenment when professors of medicine such as John Gregory, Edward Percival, and the American, Benjamin Rush, were close friends of philosophers like David Hume, Adam Smith, and Thomas Reid. They continually exchanged views on matters of ethics with each other in print, at meetings of elite intellectual groups, and at the dinner table. Then something happened, physicians and humanists quit talking with each other. In searching for the causes of the collapse, this book identifies shifts in the social class of physicians, developments in medical science, and changes in the patterns of medical education. Only in the past three decades has the dialogue resumed as physicians turned to humanists for help just when humanists wanted their work to be relevant to real-life social problems. Again, the book asks why, finding answers in the shift from acute to chronic disease as the dominant pattern of illness, the social rights revolution of the 1960's, and the increasing dissonance between physician ethics and ethics outside medicine. The book tells the critical story of how the breakdown in communication between physicians and humanists occurred and how it was repaired when new developments in medicine together with a social revolution forced the leaders of these two fields to resume their dialogue. (shrink)

How one goes about teaching medical ethics greatly depends upon one's interpretation of the discipline itself. Before discussing pedagogical isslIes, the primary focus ofthe paper, I will address the question of what "philosophical" medical ethics is and is not. I will then suggest some alternative approac:hes forincluding such material in a variety of different contexts, including courses geared toward philosophy students, those focusing on undergraduate students preparing for careers in one of the health care professions, and (...) those actually within professional schools, primarily medical schools, with which I am mostfamiliar. I will end with remarks on the implications of medical etllics for medicine and for philosophy. (shrink)

Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little attention has been given to the processes these committees use to facilitate decision-making. In 1990, the National Institute for Dispute Resolution in Washington, D.C., provided a planning grant from its Innovation Fund to the Institute of Public Law of the University of New Mexico School (...) of Law to look at what ethics committees can learn from facilitation and mediation techniques. The study's thesis was that, if adapted for use by medical ethics committees, facilitation and mediation techniques can be helpful to those bodies in case review consultations and in other internal committee processes. This article reports on that project. (shrink)

In this paper, we argue that lack of access to the fruits of modern medicine and the science that informs it is an important and neglected topic within bioethics and medical ethics. This is especially clear to those working in what are now termed 'resource-poor settings'- to those working, in plain language, among populations living in dire poverty. We draw on our experience with infectious diseases in some of the poorest communities in the world to interrogate the central (...) imperatives of bioethics and medical ethics. AIDS, tuberculosis, and malaria are the three leading infectious killers of adults in the world today. Because each disease is treatable with already available therapies, the lack of access to medical care is widely perceived in heavily disease-burdened areas as constituting an ethical and moral dilemma. In settings in which research on these diseases are conducted but there is little in the way of therapy, there is much talk of first world diagnostics and third world therapeutics. Here we call for the 'resocialising' of ethics. To resocialise medical ethics will involve using the socialising disciplines to contextualise fully ethical dilemmas in settings of poverty and, a related gambit, the systematic participation of the destitute sick. Clinical research across steep gradients also needs to be linked with the interventions that are demanded by the poor and otherwise marginalised. We conclude that medical ethics must grapple more persistently with the growing problem posed by the yawning 'outcome gap' between rich and poor. (shrink)

The main object of criticism of present-day medical ethics is the standard view of the relationship between theory and practice. Medical ethics is more than the application of moral theories and principles, and health care is more than the domain of application of moral theories. Moral theories and principles are necessarily abstract, and therefore fail to take account of the sometimes idiosyncratic reality of clinical work and the actual experiences of practitioners. Suggestions to remedy the illnesses (...) of contemporary medical ethics focus on re-establishing the connection between the internal and external morality of medicine. This article discusses the question how to develop a theoretical perspective on medical ethical issues that connects philosophical reflection with the everyday realities of medical practice. Four steps in a comprehensive approach of medical ethics research are distinguished: (1) examine health care contexts in order to obtain a better understanding of the internal morality of these practices; this requires empirical research; (2) analyze and interpret the external morality governing health care practices; sociological study of prevalent values, norms, and attitudes concerning medical-ethical issues is required; (3) creation of new theoretical perspectives on health care practices; Jensen's theory of healthcare practices will be useful here; (4) develop a new conception of bioethics that illuminates and clarifies the complex interaction between the internal and external morality of health care practices. Hermeneutical ethics can be helpful for integrating the experiences disclosed in the empirical ethical studies, as well as utilizing the insights gained from describing the value-contexts of health care practices. For a critical and normative perspective, hermeneutical ethics has to examine and explain the moral experiences uncovered, in order to understand what they tell us. (shrink)

A physician says, "I have an ethical obligation never to cause the death of a patient," another responds, "My ethical obligation is to relieve pain even if the patient dies." The current argument over the role of physicians in assisting patients to die constantly refers to the ethical duties of the profession. References to the Hippocratic Oath are often heard. Many modern problems, from assisted suicide to accessible health care, raise questions about the traditional ethics of medicine and the (...) medical profession. However, few know what the traditional ethics are and how they came into being. This book provides a brief tour of the complex story of medical ethics evolved over centuries in both Western and Eastern culture. It sets this story in the social and cultural contexts in which the work of healing was practiced and suggests that, behind the many different perceptions about the ethical duties of physicians, certain themes appear constantly, and may be relevant to modern debates. The book begins with the Hippocratic medicine of ancient Greece, moves through the Middle Ages, Renaissance and Enlightenment in Europe, and the long history of Indian and Chinese medicine, ending as the problems raised modern medical science and technology challenge the settled ethics of the long tradition. (shrink)

Mainstream philosophical discussions of ethics usually involve either a search for a problem-solving theory (such as utilitarianism), or an exploration of ontological status (of things like obligations or reasons). This book will argue that such efforts are often misplaced. Instead, the proper starting point should always be the actual words and deeds of ordinary people in ordinary disagreements; for the ethical concepts in play can only derive their full meaning within the context of ordinary human lives. This will require (...) a better understanding of the 'ordinary', and of what it means to lead a life. (shrink)

The 2018 Varsity Medical Ethics debate convened upon the motion: “This house believes that the constant monitoring of our health does more harm than good”. This annual debate between students from the Universities of Oxford and Cambridge is now in its tenth year. This year’s debate was hosted at the Oxford Union on 8th of February 2018, with Oxford winning for the Opposition, and was the catalyst for the collation and expansion of ideas in this paper.New technological devices (...) have the potential to enhance patient autonomy, improve patient safety, simplify the management of chronic diseases, increase connectivity between patients and healthcare professionals and assist individuals to make lifestyle changes to improve their health. However, these are pitted against an encroachment of technology medicalising the individual and home, an exacerbation of health inequalities, a risk to the security of patient data, an alteration of the doctor-patient relationship dynamic and an infringement on individual self-identity. This paper will draw upon and develop these concepts, while contending arguments for and against constant health monitoring. This is not a review of medical devices and health monitoring, but a reflective development and more detailed elaboration of the main points highlighted in the 2018 Varsity Medical Ethics debate. (shrink)

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of (...) Bioethics International Congress (June, 2010). (shrink)

The first editorial in the Journal of Medical Ethics described an ambition to be a ‘forum for the reasoned discussion of moral issues arising from the provision of medical care’.1 While that statement of intent might seem broad, it is one that has been reaffirmed by successive editors of the journal.2–4 It is an aim that aligns with the mission statement of JME and The Institute of Medical Ethics, to promote ‘ethical reflection and conduct in (...) scientific research and medical conduct.’ It is an end worthy of some reflection because it illuminates how the journal has developed and implies a conception of what good medical ethics is. During his time as editor, Raanan Gillon was a champion for philosophical medical ethics and he wrote an excellent and influential book on that topic.5 In the July issue of JME, Julian Savulescu, Tom Douglas and Dominic Wilkinson affirm the importance of philosophical medical ethics and ably demonstrate why it matters in the Charlie Gard case.6 Does that mean papers published in the JME must be philosophical? In one sense, clearly no and in another yes. Good medical ethics is not philosophy. The degree of scepticism, the narrow focus on a search for truth, the technical nature of some philosophy and it not needing to deliver normative or practical ethical conclusions mean that a narrowly philosophical approach is unlikely to be good medical ethics. JME has never been a narrowly philosophical journal and the perils of this were described well by its first editor: > We therefore intend to put editorial weight behind what we consider to be carefully argued and well informed judgments and not to allow every value …. (shrink)

This book examines the moral luck paradox, relating it to Kantian, consequentialist and virtue-based approaches to ethics. It also applies the paradox to areas in medical ethics, including allocation of scarce medical resources, informed consent to treatment, withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing and medical research. If risk and luck are taken seriously, it might seem to follow that we cannot develop any definite moral standards, that we are doomed to moral relativism. (...) However, Dickenson offers strong counter-arguments to this view that enable us to think in terms of universal standards. (shrink)

When we applied for the editorship of the JME 7 years ago, we said that we considered the JME to be the most important journal in medicine. The most profound questions that health professionals face are not scientific or technical, but ethical. Our enormous scientific and medical progress already outstrips our capability to provide treatment. Life can be prolonged at enormous cost, sometimes far beyond the point that the individual appears to be gaining a net benefit from that life. (...) Science can tell us how to achieve something, but it cannot tell us whether we should achieve that end—whether it is good. For that, we need ethics. Ethics grows in importance as our technology creates new possibilities. Where there are no options, there are no ethical questions. However, once there are options, there arise pressing questions about whether to pursue them. We require values and principles to decide how to use medicine and science. During the last 7 years, issues like the creation of brain organoids, human non-human chimeras, mitochondrial transfer, gene editing of embryos and in vitro gametogenesis have grown in prominence. These raise deep questions about moral status and how it should be determined, the limits of modification of humans, and what is good in life. As editors of the JME, we are proud of our small contribution to thinking about these challenges. We are grateful to the hard work of our associate editors and administrative staff, but there is still much more to do. During our term as editors, we have published papers from diverse perspectives, on a wide range of topics. We have seen vigorous debate within the pages of the journal and have often sought to deliberately encourage that debate …. (shrink)

American society has a history of turning to physicians during times of extreme need, from plagues in the past to recent outbreaks of communicable diseases. This public instinct comes from a deep seated trust in physician duty that has been earned over the centuries through dedicated and selfless care, often in the face of personal risks. As dangers facing our communities include terroristic events physicians must be adequately prepared to respond, both medically and ethically. While the ethical principles that govern (...) physician behavior—beneficence, nonmaleficence, autonomy, and social justice—are unchanging, fundamental doctrines must change with the new risks inherent to terroristic events. Responding to mass casualty disasters caused by terrorists, natural calamities, and combat continue to be challenging frontiers in medicine. Preparing physicians to deal with the consequences of a terroristic disease must include understanding the ethical challenges that can occur. (shrink)

Almost all articles on education in medical ethics present proposals for or describe experiences of teaching students in different health professions. Since experienced staff also need such education, the purpose of this paper is to exemplify and discuss educational approaches that may be used after graduation. As an example we describe the experiences with a five-day European residential course on ethics for neonatal intensive care personnel. In this multidisciplinary course, using a case-based approach, the aim was to (...) enhance the participants' understanding of ethical principles and their relevance to clinical and research activities. Our conclusion is that working with realistic cases encourages practising nurses and physicians to apply their previous knowledge and new concepts learnt in the course, thus helping them to bridge the gap between theory and practice. (shrink)

This new edition of Law and Medical Ethics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.