By Paul J. Ford (editor), Denise M. Dudzinski (editor)
Medical ethicists stumble upon the main emotionally eviscerating clinical situations attainable. they fight to facilitate resolutions based on strong reasoning embedded in compassionate care. This publication fills the substantial hole among present texts and the ongoing academic wishes of these really dealing with complicated ethics consultations in medical institution settings. 28 richly exact instances discover the moral reasoning, specialist concerns, and the emotional facets of those impossibly tricky consultations. The circumstances are grouped jointly by means of topic to assist instructing, dialogue development. The circumstances tell any reader who has a willing curiosity within the offerings made in real-life scientific dilemmas in addition to the emotional fee to people who paintings to enhance the occasions. On a extra complicated point, this booklet might be learn through ethics committee contributors who perform ethics consultations, person ethics specialists, clinicians who search schooling approximately complicated medical ethics circumstances, and bioethics scholars.
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Extra info for Complex Ethics Consultations: Cases that Haunt Us
The retrospective review of the case by the ethics committee provides a reminder of the importance of quality improvement. This reflection on peer review resonates with the earlier discussion by Macauley and Orr. The fourth section, Withholding therapy with a twist, addresses the traditional question of withdrawing life-sustaining therapy; except these cases all have unusual or unexpected features. Ellen Bernal begins the section attentive to process and role. Reflecting on an experience from early in her career, she describes a woman in a Catholic hospital who consistently requests discontinuation of therapy.
Not to act on such information is a moral act in itself. The very knowledge of a situation may entail a moral obligation to act, particularly if an error is unlikely to be identified or disclosed without the committee’s involvement. The authors explicitly raise the concept of moral error as well as the distinction between legal and moral accountability. In some ways Joel Potash builds on the theme of error disclosure raised by Foglia and Pearlman. He articulates the ethical reasoning underpinning the recommendation to disclose a patient’s possible exposure to Creutzfeldt-Jakob disease through improperly sterilized surgical instruments.
In such cases, healthcare professionals are guided by the principle of proportionality, requiring that burdens of treatment be justified by the benefits accruing to the patient. When the burdens far outweigh the benefits, the goals of medicine most often shift from curative to palliative. Consideration should also be given to the “do no harm” principle. Beauchamp and Childress comment on Gerald Kelly’s explanation of proportionality: “For a therapy to be obligatory or required, it must (a) offer a reasonable prospect of 23 24 Part I: Starting at the beginning: prenatal and neonatal issues benefit, and (b) not involve excessive expense, pain, or other inconvenience.