Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issues involved in clinical medical ethics. Since the analysis of cases plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. The book includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches.
Readership: Students of medicine and moral philosophy; groups and individuals concerned with medical ethics; moral philosophers.
Terrence F. Ackerman, Professor and Chairman, and Carson Strong, Associate Professor, both at Department of Human Values and Ethics, University of Tennessee, College of Medicine, Memphis
"`The extensive case discussions and the thoroughness both of the topics as well as analyses, make this an ideal casebook for ethics eommittee study.' Theoretical Medicine"
1: Paternalism in the Therapeutic Relationship 1.1: Ambivalence Toward Electroconvulsive Therapy 1.2: Treatment Refusal in the Medical Intensive Care Unit 1.3: An Uncooperative Leukemia Patient 1.4: Rehabilitation of a Dependent Patient 1.5: Alternative Approaches to Informed Consent 1.6: Previous Refusal of Treatment by a Presently Comatose Patient 1.7: A Family's Refusal of Blood Transfusions for a Mother and Her Son 1.8: Deciding Whether to Discharge a Suicidal Patient 1.9: A Request for Sex-Reassigning Surgery 1.10: Divulging Information Concerning an Infant's Condition 2: Duties to Patient and Family 2.1: A Daughter's Insistence on Aggressive Treatment 2.2: Parental Refusal of Cancer Treatment on Religious Grounds 2.3: Informed Consent and the Dying Adolescent 2.4: Treatment Refusal for an Infant with Possible Brain Damage 2.5: Venereal Disease and Adolescent Confidentiality 2.6: Contraceptives for an Adolescent 2.7: Request for Abortion for a Retarded Daughter 2.8: Request for Hysterectomy for a Retarded Eleven-Year-Old 2.9: Conflict About Maintaining a Brain-Dead Woman for the Sake of Her Fetus 2.10: Choosing the Method of Delivery for a Fetus with Hydrocephalus 3: Deciding for Others 3.1: A Bedridden and Cognitively Impaired Elderly Patient 3.2: Who Should Decide for a Patient in Persistent Vegetative State? 3.3: Nasogastric Tube Feedings for an Elderly Stroke Patient 3.4: A Prolonged Stay in the Neonatal ICU 3.5: Deciding Treatment When the Preliminary Diagnosis is Trisomy 18 3.6: Risk/Benefit Assessment of Surgery for a Child Suffering from Strokes 3.7: Responding to a Family's Decision for Laetrile 3.8: Selecting Therapy for a Mentally Retarded Teenager 3.9: Birth Control for a Retarded Woman 3.10: A Family's Lack of Commitment 4: Medical Research Involving Human Subjects 4.1: Limited Consent in Alcoholism Research 4.2: Disclosure of Preliminary Results in a Randomized Clinical Trial 4.3: Constraints on Consent in a Phase I Clinical Trial 4.4: Proxy Consent for Incompetent Trauma Patients 4.5: Undue Inducement in the Recruitment of Research Subjects 4.6: Nontherapeutic Research Procedures Involving Children 4.7: Discomfort from Repeated Nontherapeutic Research Procedures Involving Competent Adults 4.8: Physicians' Treatment Preferences and Recruitment of Subjects for a Randomized Clinical Trial 4.9: Parental Preferences and a Child's Involvement in a Randomized Clinical Trial 4.10: Compensating Research Injuries 5: Physicians, Third Parties, and Society 5.1: Request for Surgery the Physician Considers Unnecessary 5.2: Providing Free Care 5.3: Risk of Litigation as a Factor in Decision Making 5.4: Pressures to Provide Customary Care 5.5: Confidentiality and Child Abuse 5.6: Rejection of a Consultant's Advice 5.7: Abortion Resulting in a Live Birth 5.8: Costly Nutrition for a Terminal Patient 5.9: Cost Factors in the Choice of Treatment for Kidney Stone Disease 5.10: Artificial Insemination for a Single Woman Topical Index to Cases
