60 results match your criteria Philosophy Ethics and Humanities in Medicine PEHM [Journal]


Renewing Medicine's basic concepts: on ambiguity.

Philos Ethics Humanit Med 2018 07 4;13(1). Epub 2018 Jul 4.

Rice Family Fellow in Bioethics and the Humanities, The Hastings Center, 21 Malcolm Gordon Road, Garrison, NY, 10524-4125, USA.

Background: Edmund Pellegrino lamented that the cultural climate of the industrialized West had called the fundamental means and ends of medicine into question, leading him to propose a renewed reflection on medicine's basic concepts, including health, disease, and illness. My aim in this paper is take up Pellegrino's call. I argue that in order to usher in this renewal, the concept of ambiguity should take on a guiding role in medical practice, both scientific and clinical. Read More

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http://dx.doi.org/10.1186/s13010-018-0061-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032601PMC
July 2018
1 Read

Expertise in evidence-based medicine: a tale of three models.

Authors:
Sarah Wieten

Philos Ethics Humanit Med 2018 02 2;13(1). Epub 2018 Feb 2.

Philosophy Department, Indiana University of Pennsylvania, Humanities and Social Sciences Building, 505, 981 Grant Street, Indiana, PA, 15705, USA.

Background: Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against-the authoritarian pronouncements about "best" interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. Read More

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http://dx.doi.org/10.1186/s13010-018-0055-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797352PMC
February 2018
4 Reads

A meta-science for a global bioethics and biomedicine.

Authors:
David S Basser

Philos Ethics Humanit Med 2017 11 7;12(1). Epub 2017 Nov 7.

Philosophy, School of Humanities, University of Tasmania, Hobart, TAS, Australia.

Background: As suggested by Shook and Giordano, understanding and therefore addressing the urgent international governance issues around globalizing bio-medical/technology research and applications is limited by the perception of the underlying science.

Methods: A philosophical methodology is used, based on novel and classical philosophical reflection upon existent literature, clinical wisdoms and narrative theory to discover a meta-science and telos of humankind for the development of a relevant and defendable global biomedical bioethics.

Results: In this article, through pondering an integrative systems approach, I propose a biomedical model that may provide Western biomedicine with leadership and interesting insight into the unity beyond the artificial boundaries of its traditional divisions and the limit between physiological and pathological situations (health and disease). Read More

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http://dx.doi.org/10.1186/s13010-017-0051-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674752PMC
November 2017
2 Reads

Conceptualizing suffering and pain.

Philos Ethics Humanit Med 2017 09 29;12(1). Epub 2017 Sep 29.

Department of Philosophy and Research Center Medical Humanities, University of Innsbruck, Innrain 52d, A6020, Innsbruck, Austria.

Background: This article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel's idea of persons as "intact beings") are critically discussed with such purpose.

Methods: A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain. Read More

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http://dx.doi.org/10.1186/s13010-017-0049-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621131PMC
September 2017
3 Reads

Context and scale: Distinctions for improving debates about physician "rationing".

Philos Ethics Humanit Med 2017 08 29;12(1). Epub 2017 Aug 29.

Departments of Philosophy and Medicine, Georgetown University, 37th and O Streets NW, Washington, DC, 20057, USA.

Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of the decision (macro vs. Read More

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http://dx.doi.org/10.1186/s13010-017-0048-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576279PMC
August 2017
5 Reads
1 Citation

Developing an informational tool for ethical engagement in medical tourism.

Philos Ethics Humanit Med 2017 08 25;12(1). Epub 2017 Aug 25.

Department of Geography, Simon Fraser University, Robert C. Brown Building, 8888 University Drive, Burnaby, BC, Canada.

Background: Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. Read More

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http://dx.doi.org/10.1186/s13010-017-0045-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574152PMC
August 2017
6 Reads

A four-part working bibliography of neuroethics: Part 4 - Ethical issues in clinical and social applications of neuroscience.

Philos Ethics Humanit Med 2017 05 31;12(1). Epub 2017 May 31.

Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, and Department of Neurology, Georgetown University Medical Center, Washingotn, DC, USA.

Background: As a discipline, neuroethics addresses a range of questions and issues generated by basic neuroscientific research (inclusive of studies of putative neurobiological processes involved in moral and ethical cognition and behavior), and its use and meanings in the clinical and social spheres. Here, we present Part 4 of a four-part bibliography of the neuroethics literature focusing on clinical and social applications of neuroscience, to include: the treatment-enhancement discourse; issues arising in neurology, psychiatry, and pain care; neuroethics education and training; neuroethics and the law; neuroethics and policy and political issues; international neuroethics; and discourses addressing "trans-" and "post-" humanity.

Methods: To complete a systematic survey of the literature, 19 databases and 4 individual open-access journals were employed. Read More

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http://dx.doi.org/10.1186/s13010-017-0043-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452349PMC
May 2017
8 Reads

Varsity Medical Ethics Debate 2015: should nootropic drugs be available under prescription on the NHS?

Philos Ethics Humanit Med 2016 09 13;11(1). Epub 2016 Sep 13.

St John's College, University of Cambridge, St John's Street, Cambridge, CB21TP, UK.

The 2015 Varsity Medical Ethics debate convened upon the motion: "This house believes nootropic drugs should be available under prescription". This annual debate between students from the Universities of Oxford and Cambridge, now in its seventh year, provided the starting point for arguments on the subject. The present article brings together and extends many of the arguments put forward during the debate. Read More

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http://dx.doi.org/10.1186/s13010-016-0041-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022156PMC
September 2016
4 Reads

Programs of religious/spiritual support in hospitals - five "Whies" and five "Hows".

Philos Ethics Humanit Med 2016 08 22;11(1). Epub 2016 Aug 22.

Centro Universitário São Camilo, Rua Montesquieu 371, CEP 04116-190, São Paulo, SP, Brazil.

A contemporary orientation of the hospital experience model must encompass the clients' religious-spiritual dimension. The objective of this paper is to share a previous experience, highlighting at least five reasons hospitals should invest in this direction, and an equal number of steps required to achieve it. In the first part, the text discourses about five reasons to invest in religious-spiritual support programs: 1. Read More

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http://dx.doi.org/10.1186/s13010-016-0039-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994237PMC
August 2016
3 Reads

Medical professionalism: what the study of literature can contribute to the conversation.

Philos Ethics Humanit Med 2015 Jun 27;10:10. Epub 2015 Jun 27.

William Ray Moore Endowed Chair of Family Medicine and Medical Humanism, and Division of Medical Humanism and Ethics, Department of Family and Geriatric Medicine, University of Louisville, 2301S 3rd St, Louisville, KY, 40292, USA.

Medical school curricula, although traditionally and historically dominated by science, have generally accepted, appreciated, and welcomed the inclusion of literature over the past several decades. Recent concerns about medical professional formation have led to discussions about the specific role and contribution of literature and stories. In this article, we demonstrate how professionalism and the study of literature can be brought into relationship through critical and interrogative interactions based in the literary skill of close reading. Read More

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http://dx.doi.org/10.1186/s13010-015-0030-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484639PMC
June 2015
3 Reads

An explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death.

Philos Ethics Humanit Med 2015 Mar 11;10. Epub 2015 Mar 11.

Division of Pediatric Critical Care, and Medical Director, Extracorporeal Life Support Program at Montreal Children's Hospital, McGill University Health Centre, 2300 Rue Tupper, Montréal, QC, H3H 1P3, Canada.

Introduction: This paper explores definitions of death from the perspectives of several world and indigenous religions, with practical application for health care providers in relation to end of life decisions and organ and tissue donation after death. It provides background material on several traditions and explains how different religions derive their conclusions for end of life decisions from the ethical guidelines they proffer.

Methods: Research took several forms beginning with a review of books and articles written by ethicists and observers of Bön, Buddhism, Christianity, Hinduism, Indigenous Traditions, Islam, Judaism, Shinto and Taoism. Read More

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http://dx.doi.org/10.1186/s13010-015-0025-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396881PMC
March 2015
5 Reads

Explaining and responding to the Ebola epidemic.

Authors:
Solomon Benatar

Philos Ethics Humanit Med 2015 Mar 4;10. Epub 2015 Mar 4.

Bioethics Centre, Philosophy Department, Upper Campus, University of Cape Town, 3.03 Humanities Building, University Ave, Rondebosch, Cape Town, South Africa.

The Ebola epidemic in West Africa is not merely a biomedical problem that can be seen in isolation and dealt with only through emergency medical rescue processes. The ethical dilemmas surfaced by this epidemic are also not confined to the usual micro-ethical problems associated with medical care and medical research. The pandemic, as one of many manifestations of failed human and social development that has brought the world to dangerous 'tipping points', requires deep introspection and action to address upstream causal processes. Read More

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http://dx.doi.org/10.1186/s13010-015-0027-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352292PMC
March 2015
3 Reads

The right to health, health systems development and public health policy challenges in Chad.

Philos Ethics Humanit Med 2015 Feb 15;10. Epub 2015 Feb 15.

Georgetown Jesuit Community, PO Box 571200, Washington, DC, 20057, USA.

Background: There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Read More

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http://dx.doi.org/10.1186/s13010-015-0023-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336701PMC
February 2015
2 Reads

Discourse on medicine: meditative and calculative approaches to ethics from an international perspective.

Philos Ethics Humanit Med 2014 Nov 7;9:18. Epub 2014 Nov 7.

Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada.

Heidegger's two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries (Canada, China, India, Ireland, Japan, Korea, & Thailand). Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking (76%) with emphasis on economic concerns. Read More

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http://peh-med.biomedcentral.com/articles/10.1186/1747-5341-
Publisher Site
http://dx.doi.org/10.1186/1747-5341-9-18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304063PMC
November 2014
6 Reads

Spanning our differences: moral psychology, physician beliefs, and the practice of medicine.

Philos Ethics Humanit Med 2014 Nov 4;9:17. Epub 2014 Nov 4.

Biomedical Ethics Research Unit, Program in Professionalism and Ethics, Division of Health Care Policy and Research, Division of General Internal Medicine, Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.

Moral pluralism is the norm in contemporary society. Even the best philosophical arguments rarely persuade moral opponents who differ at a foundational level. This has been vividly illustrated in contemporary debates in bioethics surrounding contentious issues such as abortion and euthanasia. Read More

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http://dx.doi.org/10.1186/1747-5341-9-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304047PMC
November 2014
4 Reads

Ebola, epidemics, and ethics - what we have learned.

Authors:
G Kevin Donovan

Philos Ethics Humanit Med 2014 Oct 24;9:15. Epub 2014 Oct 24.

Pellegrino Center for Clinical Bioethics, Georgetown University Medical School, Bldg, D, Rm 236, 4000 Reservoir Road, N,W,, Washington, DC 20007-2197, USA.

The current Ebola epidemic has presented challenges both medical and ethical. Although we have known epidemics of untreatable diseases in the past, this particular one may be unique in the intensity and rapidity of its spread, as well as ethical challenges that it has created, exacerbated by its geographic location. We will look at the infectious agent and the epidemic it is causing, in order to understand the ethical problems that have arisen. Read More

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http://dx.doi.org/10.1186/1747-5341-9-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209768PMC
October 2014
6 Reads

The specificity triad: notions of disease and therapeutic specificity in biomedical reasoning.

Authors:
Shai Mulinari

Philos Ethics Humanit Med 2014 Oct 18;9:14. Epub 2014 Oct 18.

Department of Sociology, Faculty of Social Sciences, Lund University, Box 114, Lund, 221 00, Sweden.

Biomedicine is typically defined as the branch of medicine that is based on the principles of biology and biochemistry. A central tenet for biomedicine is the notion of disease and therapeutic specificity, i.e. Read More

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http://dx.doi.org/10.1186/1747-5341-9-14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210362PMC
October 2014
1 Read

The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives.

Philos Ethics Humanit Med 2014 Jun 2;9:11. Epub 2014 Jun 2.

Department of Critical Care Medicine, Mayo Clinic Hospital, Mayo Clinic, Phoenix, Arizona, USA.

End-of-life organ donation is controversial in Islam. The controversy stems from: (1) scientifically flawed medical criteria of death determination; (2) invasive perimortem procedures for preserving transplantable organs; and (3) incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Read More

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http://dx.doi.org/10.1186/1747-5341-9-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047256PMC
June 2014
2 Reads

A four-part working bibliography of neuroethics: part 1: overview and reviews--defining and describing the field and its practices.

Philos Ethics Humanit Med 2014 May 16;9. Epub 2014 May 16.

Neuroethics Studies Program, Edmund D, Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC 20057, USA.

Background: Neuroethics entails investigations of neurocognitive mechanisms of morality and ethics; and studies and address of the ethical issues spawned by the use of neuroscience and its technologies to investigate cognition, emotion and actions. These two principal emphases, or what have been called "traditions" of neuroethics both mirror traditional bioethical discussions (such as debates about the safety of technological and pharmaceutical advances and ethical implications of new scientific and technological discoveries), and engage discourse about neuroscientific investigations of (proto-moral and moral) cognition, emotions and behaviors, and what such findings may mean for human beliefs and conduct - from the individual to the political levels.Given the growth, range, and rapid maturation of the field of neuroethics we provide an iterative, four-part document that affords a repository of international papers, books, and chapters that address the field in overview, and present discussion(s) of more particular aspects and topics of neuroethics. Read More

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http://peh-med.biomedcentral.com/articles/10.1186/1747-5341-
Publisher Site
http://dx.doi.org/10.1186/1747-5341-9-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047768PMC
May 2014
4 Reads

Retrospective diagnosis of a famous historical figure: ontological, epistemic, and ethical considerations.

Authors:
Osamu Muramoto

Philos Ethics Humanit Med 2014 May 28;9:10. Epub 2014 May 28.

Center for Ethics in Health Care, Oregon Health & Science University, 3181 S,W, Sam Jackson Park Rd, UHN-86, Portland, OR 97239-3098, USA.

The aim of this essay is to elaborate philosophical and ethical underpinnings of posthumous diagnosis of famous historical figures based on literary and artistic products, or commonly called retrospective diagnosis. It discusses ontological and epistemic challenges raised in the humanities and social sciences, and attempts to systematically reply to their criticisms from the viewpoint of clinical medicine, philosophy of medicine, particularly the ontology of disease and the epistemology of diagnosis, and medical ethics. The ontological challenge focuses on the doubt about the persistence of a disease over historical time, whereas the epistemic challenge disputes the inaccessibility of scientific verification of a diagnosis in the past. Read More

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http://dx.doi.org/10.1186/1747-5341-9-10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049481PMC
May 2014
5 Reads

Has the sanctity of life law 'gone too far'?: analysis of the sanctity of life doctrine and English case law shows that the sanctity of life law has not 'gone too far'.

Philos Ethics Humanit Med 2014 Feb 22;9. Epub 2014 Feb 22.

Imperial College School of Medicine, Sir Alexander Fleming Building, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.

The medical profession consistently strives to uphold patient empowerment, equality and safety. It is ironic that now, at a time where advances in technology and knowledge have given us an increased capacity to preserve and prolong life, we find ourselves increasingly asking questions about the value of the lives we are saving. A recent editorial by Professor Raanan Gillon questions the emphasis that English law places on the sanctity of life doctrine. Read More

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http://dx.doi.org/10.1186/1747-5341-9-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936863PMC
February 2014
6 Reads

Access to nutritious food, socioeconomic individualism and public health ethics in the USA: a common good approach.

Philos Ethics Humanit Med 2013 Oct 29;8:16. Epub 2013 Oct 29.

Département de Santé Publique, Faculté des Sciences de la Santé de l'Université de N'djaména, Avenue Mobutu, B,P, 1117 N'djaména, Tchad.

Good nutrition plays an important role in the optimal growth, development, health and well-being of individuals in all stages of life. Healthy eating can reduce the risk of chronic diseases, such as heart disease, stroke, diabetes and some types of cancer. However, the capitalist mindset that shapes the food environment has led to the commoditization of food. Read More

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http://dx.doi.org/10.1186/1747-5341-8-16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231366PMC
October 2013
5 Reads

Honeymoon, medical treatment or big business? An analysis of the meanings of the term "reproductive tourism" in German and Israeli public media discourses.

Philos Ethics Humanit Med 2013 Aug 20;8. Epub 2013 Aug 20.

Faculty of Law, Tel Aviv University, Ramat Aviv, PB 39040, Tel Aviv 69978, Israel.

Background/introduction: Infertile couples that travel to another country for reproductive treatment do not refer to themselves as "reproductive tourists". They might even be offended by this term. "Tourism" is a metaphor with hidden connotations. Read More

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http://dx.doi.org/10.1186/1747-5341-8-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854005PMC
August 2013
4 Reads

Cardiovascular medicine at face value: a qualitative pilot study on clinical axiology.

Philos Ethics Humanit Med 2013 Mar 27;8. Epub 2013 Mar 27.

Grupo transfuncional en ética clínica, Centro Médico Nacional Siglo XXI, IMSS, Av. Cuauhtémoc 330 Col. Doctores, México 06720, DF, Mexico.

Introduction: Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Read More

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http://dx.doi.org/10.1186/1747-5341-8-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620706PMC
March 2013
11 Reads

The right to practice medicine without repercussions: ethical issues in times of political strife.

Authors:
Leith Hathout

Philos Ethics Humanit Med 2012 Sep 13;7:11. Epub 2012 Sep 13.

Department of Biology, Stanford University, P.O. Box 11042, Stanford, CA 9430--1042, USA.

This commentary examines the incursion on the neutrality of medical personnel now taking place as part of the human rights crises in Bahrain and Syria, and the ethical dilemmas which these incursions place not only in front of physicians practicing in those nations, but in front of the international community as a whole.In Bahrain, physicians have recently received harsh prison terms, apparently for treating demonstrators who clashed with government forces. In Syria, physicians are under the same political pressure to avoid treating political demonstrators or to act as informants against their own patients, turning them in to government authorities. Read More

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http://dx.doi.org/10.1186/1747-5341-7-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3511879PMC
September 2012
2 Reads

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis.

Philos Ethics Humanit Med 2012 May 23;7. Epub 2012 May 23.

Department of Psychiatry, Yale School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Read More

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http://dx.doi.org/10.1186/1747-5341-7-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403926PMC
May 2012
21 Reads

The six most essential questions in psychiatric diagnosis: a pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis.

Philos Ethics Humanit Med 2012 Jul 5;7. Epub 2012 Jul 5.

Department of Psychiatry, Yale School of Medicine, 300 George St,, Suite 901, New Haven,, CT 06511, USA.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM--whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Read More

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http://dx.doi.org/10.1186/1747-5341-7-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390269PMC
July 2012
23 Reads

Accountability and pediatric physician-researchers: are theoretical models compatible with Canadian lived experience?

Philos Ethics Humanit Med 2011 Oct 5;6:15. Epub 2011 Oct 5.

The Hospital for Sick Children, c/o Bioethics Department, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.

Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories. Read More

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http://dx.doi.org/10.1186/1747-5341-6-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225294PMC
October 2011
9 Reads
1 Citation

The institutional review board is an impediment to human research: the result is more animal-based research.

Authors:
Mark J Rice

Philos Ethics Humanit Med 2011 Jun 7;6:12. Epub 2011 Jun 7.

Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610-0254, USA.

Biomedical research today can be generally classified as human-based or nonhuman animal-based, each with separate and distinct review boards that must approve research protocols. Researchers wishing to work with humans or human tissues have become frustrated by the required burdensome approval panel, the Institutional Review Board. However, scientists have found it is much easier to work with the animal-based research review board, the Institutional Animal Care and Use Committee. Read More

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http://peh-med.biomedcentral.com/articles/10.1186/1747-5341-
Publisher Site
http://dx.doi.org/10.1186/1747-5341-6-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127833PMC
June 2011
2 Reads

The being of leadership.

Authors:
Wiley W Souba

Philos Ethics Humanit Med 2011 Feb 24;6. Epub 2011 Feb 24.

School of Medicine, Dartmouth College, Dartmouth Medical School, Hanover, NH, USA.

The ethical foundation of the medical profession, which values service above reward and holds the doctor-patient relationship as inviolable, continues to be challenged by the commercialization of health care. This article contends that a realigned leadership framework - one that distinguishes being a leader as the ontological basis for what leaders know, have, and do - is central to safeguarding medicine's ethical foundation. Four ontological pillars of leadership - awareness, commitment, integrity, and authenticity - are proposed as fundamental elements that anchor this foundation and the basic tenets of professionalism. Read More

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http://dx.doi.org/10.1186/1747-5341-6-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050817PMC
February 2011
2 Reads

No departure to "Pandora"? Using critical phenomenology to differentiate "naive" from "reflective" experience in psychiatry and psychosomatic medicine (a comment on Schwartz and Wiggins, 2010).

Philos Ethics Humanit Med 2010 Oct 31;5:15. Epub 2010 Oct 31.

Department of Philosophy, Karl Franzens University Graz, Graz, Austria.

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between "natural" and a "reflective" experience built into phenomenological method itself. Read More

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http://dx.doi.org/10.1186/1747-5341-5-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984418PMC
October 2010
4 Reads

How clinicians make (or avoid) moral judgments of patients: implications of the evidence for relationships and research.

Authors:
Terry E Hill

Philos Ethics Humanit Med 2010 Jul 9;5:11. Epub 2010 Jul 9.

Department of Medicine, University of California, San Francisco, USA.

Physicians, nurses, and other clinicians readily acknowledge being troubled by encounters with patients who trigger moral judgments. For decades social scientists have noted that moral judgment of patients is pervasive, occurring not only in egregious and criminal cases but also in everyday situations in which appraisals of patients' social worth and culpability are routine. There is scant literature, however, on the actual prevalence and dynamics of moral judgment in healthcare. Read More

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http://dx.doi.org/10.1186/1747-5341-5-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914676PMC
July 2010
4 Reads

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines.

Philos Ethics Humanit Med 2010 Jun 9;5. Epub 2010 Jun 9.

California Lyme Disease Association, Ukiah, CA, USA.

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. Read More

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http://dx.doi.org/10.1186/1747-5341-5-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901226PMC
June 2010
2 Reads

Should the NHS be privatized? Annual varsity medical debate - London, 22 January 2010.

Philos Ethics Humanit Med 2010 May 11;5. Epub 2010 May 11.

University of Cambridge, UK.

The Varsity Medical Debate, between Oxford and Cambridge Universities, brings together practitioners and the public, professors, pupils and members of the polis, to facilitate discussion about ethics and policy within healthcare. The motion on privatizing the National Health Service (NHS) was specifically chosen to reflect the growing sentiment in the UK where further discourse upon models of healthcare was required. Time and again, the outcome of British elections pivots upon the topic of financial sustainability of the NHS. Read More

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http://dx.doi.org/10.1186/1747-5341-5-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878290PMC
May 2010
7 Reads

Psychosomatic medicine and the philosophy of life.

Philos Ethics Humanit Med 2010 Jan 21;5. Epub 2010 Jan 21.

Department of Psychiatry, University of Hawaii 1106 Blackacre Trail, Austin, Texas, 78746, USA.

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Read More

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http://dx.doi.org/10.1186/1747-5341-5-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823620PMC
January 2010
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Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences.

Philos Ethics Humanit Med 2009 Sep 22;4:15. Epub 2009 Sep 22.

Bioethics, Policy and Law Program, School of Life Sciences, Center for Biology and Society, Arizona State University, 300 East University Drive, Tempe, Arizona 85287, USA.

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. Read More

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http://dx.doi.org/10.1186/1747-5341-4-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757028PMC
September 2009
3 Reads

Healing relationships and the existential philosophy of Martin Buber.

Philos Ethics Humanit Med 2009 Aug 13;4:11. Epub 2009 Aug 13.

University of Medicine and Dentistry of New Jersey, Department of Family Medicine, Robert Wood Johnson Medical School, One Worlds Fair Drive, Somerset, NJ 08873, USA.

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. Read More

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http://dx.doi.org/10.1186/1747-5341-4-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733137PMC
August 2009
2 Reads

For an indeterministic ethics. The emptiness of the rule in dubio pro vita and life cessation decisions.

Philos Ethics Humanit Med 2009 May 14;4. Epub 2009 May 14.

Department of Anaesthesiology and Intensive Care Medicine, Ernst Moritz Arndt University, Greifswald, Germany.

It is generally claimed that there exist exceptional circumstances when taking human life may be approved and when such actions may be justified on moral grounds. Precise guidelines in the medical field for making such decisions concerning patients who are terminally ill or have irreparable injuries incompatible with a bearable life, are difficult to establish. Recommendations that take the particular logical form of a rule, such as "in dubio pro vita", "when in doubt favour life") have been suggested and in some countries incorporated into legal texts (Germany). Read More

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http://dx.doi.org/10.1186/1747-5341-4-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690600PMC
May 2009
5 Reads
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Living apart together: reflections on bioethics, global inequality and social justice.

Philos Ethics Humanit Med 2008 Dec 7;3:25. Epub 2008 Dec 7.

Departments of Dental Ecology, Social Medicine and Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA.

Significant inequalities in health between and within countries have been measured over the past decades. Although these inequalities, as well as attempts to improve sub-standard health, raise profound issues of social justice and the right to health, those working in the field of bioethics have historically tended to devote greater attention to ethical issues raised by new, cutting-edge biotechnologies such as life-support cessation, genomics, stem cell research or face transplantation. This suggests that bioethics research and scholarship may revolve around issues that, while fascinating and important, currently affect only a small minority of the world's population. Read More

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http://dx.doi.org/10.1186/1747-5341-3-25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613380PMC
December 2008
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The 'Brain Drain' of physicians: historical antecedents to an ethical debate, c. 1960-79.

Philos Ethics Humanit Med 2008 Nov 10;3:24. Epub 2008 Nov 10.

History of Medicine Unit, HSC 3N10, McMaster University, 1200 Main Street West, Hamilton Ontario L8N 3Z5, Canada.

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. Read More

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http://dx.doi.org/10.1186/1747-5341-3-24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613146PMC
November 2008
20 Reads

"Enhanced" interrogation of detainees: do psychologists and psychiatrists participate?

Philos Ethics Humanit Med 2008 Sep 25;3:21. Epub 2008 Sep 25.

New York Medical College, USA.

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Read More

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http://dx.doi.org/10.1186/1747-5341-3-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561033PMC
September 2008
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Ethical challenges with the left ventricular assist device as a destination therapy.

Philos Ethics Humanit Med 2008 Aug 11;3:20. Epub 2008 Aug 11.

Department of Physical Medicine and Rehabilitation, Mayo Clinic Hospital, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA.

The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Read More

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http://dx.doi.org/10.1186/1747-5341-3-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527574PMC
August 2008
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Foucault's "fearless speech" and the transformation and mentoring of medical students.

Philos Ethics Humanit Med 2008 Apr 17;3:12. Epub 2008 Apr 17.

Department of Anesthesiology, University of Toledo, College of Medicine, 3000 Arlington Avenue, Toledo, Ohio 43614, USA.

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the ancient Greek word parrhesia, Foucault's analysis of free speech is relevant to the mentoring of medical students. This is especially true given the educational and social need to transform future physicians into able citizens who practice a fearless freedom of expression on behalf of their patients, the public, the medical profession, and themselves in the public and political arena. Read More

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http://dx.doi.org/10.1186/1747-5341-3-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2346461PMC
April 2008
3 Reads

Death, organ transplantation and medical practice.

Philos Ethics Humanit Med 2008 Feb 4;3. Epub 2008 Feb 4.

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to "strong irreversibility" (death beyond the reach of resuscitative efforts to restore life) as a necessary criterion that patients must meet before physicians can declare them to be dead. Sam Shemie, who defends our current practice of NHBD, holds that in fact physicians consider patients to be dead or not according to physician intention to resuscitate or not. Read More

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http://dx.doi.org/10.1186/1747-5341-3-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276227PMC
February 2008
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Why the way we consider the body matters - reflections on four bioethical perspectives on the human body.

Authors:
Silke Schicktanz

Philos Ethics Humanit Med 2007 Dec 4;2:30. Epub 2007 Dec 4.

University of Göttingen, Dept. of Medical Ethics and History of Medicine, Humboldtallee 36, 37073 Göttingen, Germany.

Background: Within the context of applied bioethical reasoning, various conceptions of the human body are focused upon by the author in relation to normative notions of autonomy.

Results: The author begins by descriptively exploring some main positions in bioethics from which the "body" is conceptualized. Such positions conflict: the body is that which is constitutive of the individual's experience and perception, or it is conceived of materially or mechanistically; or as a constructed locus, always historically and culturally transformed. Read More

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http://dx.doi.org/10.1186/1747-5341-2-30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2180175PMC
December 2007
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Empirical investigation of the ethical reasoning of physicians and molecular biologists - the importance of the four principles of biomedical ethics.

Philos Ethics Humanit Med 2007 Oct 25;2:23. Epub 2007 Oct 25.

Centre for Bioethics and Nanoethics, University of Aarhus, Aarhus C, Denmark.

Background: This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Read More

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http://dx.doi.org/10.1186/1747-5341-2-23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2186350PMC
October 2007
4 Reads

How new is the new philosophy of psychiatry?

Authors:
Damiaan Denys

Philos Ethics Humanit Med 2007 Oct 20;2:22. Epub 2007 Oct 20.

Department of Psychiatry, AMC, University of Amsterdam, PA,2-179, PO Box 75867, 1070 AW Amsterdam, The Netherlands.

In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series "International Perspectives in Philosophy and Psychiatry," an international book series begun in 2003 focusing on the emerging interdisciplinary field at the interface of philosophy and psychiatry. According to Natalie Banner and Tim Thornton, the series represents a clear indication that the interdisciplinary field of philosophy of psychiatry has been flourishing lately. Philosophers and psychiatrists face a "new philosophy of psychiatry". Read More

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http://dx.doi.org/10.1186/1747-5341-2-22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2098759PMC
October 2007
2 Reads

On human self-domestication, psychiatry, and eugenics.

Authors:
Martin Brüne

Philos Ethics Humanit Med 2007 Oct 5;2:21. Epub 2007 Oct 5.

Department of Psychiatry, University of Bochum, LWL Hospital, Germany.

The hypothesis that anatomically modern homo sapiens could have undergone changes akin to those observed in domesticated animals has been contemplated in the biological sciences for at least 150 years. The idea had already plagued philosophers such as Rousseau, who considered the civilization of man as going against human nature, and eventually "sparked over" to the medical sciences in the late 19th and early 20th century. At that time, human "self-domestication" appealed to psychiatry, because it served as a causal explanation for the alleged degeneration of the "erbgut" (genetic material) of entire populations and the presumed increase of mental disorders. Read More

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http://dx.doi.org/10.1186/1747-5341-2-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082022PMC
October 2007
2 Reads

The United States Revised Uniform Anatomical Gift Act (2006): new challenges to balancing patient rights and physician responsibilities.

Philos Ethics Humanit Med 2007 Sep 12;2:19. Epub 2007 Sep 12.

Department of Physical Medicine and Rehabilitation, Mayo Clinic Hospital, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA.

Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing procurement opportunities of organs medically suitable for transplantation. Read More

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http://dx.doi.org/10.1186/1747-5341-2-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2001294PMC
September 2007
7 Reads