The metamorphosis of medical ethics: a 30-year retrospective

Article Abstract:

A physician discusses the changes in medical ethics using a philosophical framework that divides the field into four periods. The first period, in which medical ethics was solely the concern of the medical profession, dates from the time of Hippocrates to the mid-1960s. The Hippocratic oath encompasses the the physician's obligations of not doing harm, doing good and maintaining confidentiality. It also prohibits surgery, abortion, euthanasia and sexual relationships with patients. The period of 'principlism' is characterized by the adoption, through laws and court decisions, of four principles - doing good, not hurting, patient autonomy and justice. The period of 'anti-principlism' calls for medical ethics to be based more on public policy and cites the limitations of principles in actually resolving moral dilemmas. The period of crisis to come may see the rise of clinical bioethics, which focuses on the clinical application of moral decisions.

Physician and patient, Physician-patient relations, Study and teaching, Medical ethics

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Professional Medical Associations: Ethical and Practical Guidelines

Article Abstract:

Professional medical associations should follow certain basic ethical guidelines. The mission of the association should be identical to the mission of the medical profession. Associations should not become unions. All financial support must come from member dues, grants and charitable contributions and any income derived from ethical practices. No association should lend its name to any health care products or services. This includes using the name of the association in the marketing of health care products and services. The association should be governed by bylaws adopted by the members and all officers should be held accountable to the members.

Medicine, Associations, Trade and professional associations, Professional associations, Trade associations

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Decisions to Withdraw Life-Sustaining Treatment: A Moral Algorithm

Article Abstract:

The case of an elderly patient with dementia is used to develop an algorithm for handling decisions to withdraw life-sustaining treatment. In this case, the patient had a pacemaker and his family requested that it be disconnected. Disconnecting the pacemaker could be ethical provided the intention was to stop a treatment that was futile. Thus the intention would be good and the act would be morally neutral. On the other hand, it might not be ethical if it was done to hasten the patient's death.

Refusal to treat (Medicine)

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