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Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics

Almeida,José Luiz Telles de; Schramm,Fermin Roland
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/1999 Português
Relevância na Pesquisa
56.16%
Both the increasing incorporation of medical technology and new social demands (including those for health care) beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

What makes the best medical ethics journal? A North American perspective

Savulescu, J; Viens, A
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /10/2005 Português
Relevância na Pesquisa
66.14%
Objective: To establish which factors contribute to medical ethicists reviewing articles for or submitting them to medical ethics journals by consulting those who are active in this capacity.

Should medical ethics justify violence?

Kottow, M H
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /08/2006 Português
Relevância na Pesquisa
66.11%
Medical ethics needs to be on its guard against those in military or political power who would seek to subvert its most basic tenets in order to serve their own ends

Medical ethics manual: does it serve its purpose?

Nortvedt, Per
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /03/2006 Português
Relevância na Pesquisa
66.29%
World Medical Association. Ethics manual. Ferney‐Voltaire: WMA, 2005. http://www.wma.net/e/ethicsunit/pdf/manual/ethics_manual.pdf (available for download). This manual of medical ethics is meant to serve the purpose of a guiding teaching aid for medical students as well as physicians. It was decided upon and planned by the World Medical Assembly in 1999 and the work was supervised and coordinated by the WMA Ethics Unit.

Teaching medical ethics to undergraduate students in post‐apartheid South Africa, 2003–2006

Moodley, Keymanthri
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /11/2007 Português
Relevância na Pesquisa
56.34%
The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country.

Scaling ethics up and down: moral craft in clinical genetics and in global health research

Parker, Michael
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Artigo de Revista Científica
Publicado em /01/2015 Português
Relevância na Pesquisa
56.33%
This paper engages with the question of what it is to ‘do good medical ethics’ in two ways. It begins with an exploration of what it might mean to say that health professionals practise good medical ethics as part of practising good ethical medicine. Using the example of the Genethics Club, a well-established national ethics forum for genetics professionals in the UK, the paper develops an account of moral craftsmanship grounded in the concepts of shared moral commitments and practices, moral work, ethics and living morality. In the light of this discussion, the paper goes on to consider what it might mean for a specialist in medical ethics, a bioethicist, to do good medical ethics. Finally, a research agenda focusing on the challenges of thinking about good medical ethics in a global context and a proposal for an innovative approach to bioethics methodology is outlined.

Coaching as a form of instruction and a component of medical ethics education

Shaw, Marjorie Hodges (1966 - ); Curren, Randall
Fonte: University of Rochester Publicador: University of Rochester
Tipo: Tese de Doutorado Formato: Number of Pages:x, 275 leaves; Illustrations:ill. (some col.)
Português
Relevância na Pesquisa
56.36%
Thesis (Ph. D.)--University of Rochester. Margaret Warner Graduate School of Education and Human Development, 2011.; American medical schools do not have a model approach for teaching and learning medical ethics. The literature on medical ethics instruction identifies the recent revisions to accreditation requirements, which link undergraduate and graduate ethics education, as an opportunity to create a new medical pedagogy. This dissertation develops a theoretical account of “coaching,” a form of instruction that is both critical to medical ethics education and meets the new accreditation requirements. The development of this account of coaching is, in part, conceptual, supported by philosophical methods and the wider literature on coaching in music, athletics, business, and education; and, in part, empirical, stemming from research in particular medical ethics sessions taught in the third year of the University of Rochester Medical School. The method for the empirical portion of the research is qualitative description and relies in part on analytic induction. The data come from analysis of course evaluations, participant observations of the target ethics sessions, field notes following the observations, analysis of audio-recorded participant observations...

What is the difference between deontological and consequentialist theories of medical ethics?

O'Gorman, Clodagh S; Macken, Alan P; Cullen, Walter; Dunne, Colum; Higgins, M.F.
Fonte: Irish Medical Organization Publicador: Irish Medical Organization
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
Português
Relevância na Pesquisa
76.14%
peer-reviewed; Every day, every doctor, senior or junior, faces ethical decisions. From the moment you start seeing patients on the wards, there are decisions to make. And as every decision you make can/will have a significant impact on the lives of so many people – your patient, your patient’s family, you, other healthcare professionals - medical ethics can give you a framework to help you to approach some of these decisions. The aim of this brief tutorial is to introduce some theory to frame your practice.

Medical students' knowledge about end-of-life decision-making

Pinheiro,Anielli; Nakazone,Marcelo Arruda; Leal,Fernanda Silva; Pinhel,Marcela Augusta Souza; Souza,Dorotéia Rossi Silva; Cipullo,José Paulo
Fonte: Associação Brasileira de Educação Médica Publicador: Associação Brasileira de Educação Médica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 Português
Relevância na Pesquisa
56.21%
The influence of medical students' knowledge concerning end-of-life care, considering ethical theories and clinical practice, remains controversial. We aimed to investigate medical students' knowledge of bioethical concepts related to moral kinds of death (euthanasia, disthanasia, and orthothanasia) and to analyze the influence of their clinical experience on practicing such approaches in a tertiary hospital in the state of São Paulo, Brazil. We interviewed 180 medical students [distributed in Group 1 (G1) - first to third- year students, and Group 2 (G2) - fourth to sixth-year students] to evaluate the influence of the course on "medical ethics" on ethical theories and clinical practice, using a closed questionnaire. The course on "medical ethics" did not distinguish the groups (P=0.704) in relation to bioethical concepts. Neologisms such as "cacothanasia" and "idiothanasia" were incorrectly viewed as bioethical concepts by 28% of the interviewees. Moreover, 45.3% of the sample considered health care professionals incapable of managing terminally ill patients, especially G2 (29%) as compared to G1 (16.5%, P=0.031). The concept of euthanasia was accepted by 41% of sample, as compared to 98.2% for orthothanasia. Among medical students that accepted ways to abbreviate life (22.9%)...

Medical ethics as practiced by students, nurses and faculty members in Shiraz University of Medical Sciences

BAZRAFCAN, LEILA; NABEIEI, PARISA; SHOKRPOUR, NASRIN; MOADAB, NEDA
Fonte: Shiraz University of Medical Sciences Publicador: Shiraz University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em /01/2015 Português
Relevância na Pesquisa
56.16%
Introduction: Assuming any social role has obligations and fulfilling the related responsibilities has ethical aspects that must be addressed carefully. Each role requires extensive training, which usually takes place in university institutions. Ethics is applied in at least three academic areas, including: a) in education of students' personal growth, b) in patient care, and c) in university communion in population-based health care. Given the importance of this issue in the moral domain, this study examines the correlation among the students, nurses and teacher's opinions regarding principles of medical ethics at Shiraz University of Medical Sciences.

Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals

Volandes, Angelo
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /11/2007 Português
Relevância na Pesquisa
56.28%
The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions.

Teaching medical ethics to experienced staff: participants, teachers and method

Nilstun, T.; Cuttini, M.; Saracci, R.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /12/2001 Português
Relevância na Pesquisa
66.16%
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.

The WMA on medical ethics—some critical comments

Holm, S
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /03/2006 Português
Relevância na Pesquisa
66.11%
Because the WMA's new manual contains a partially partisan view of what constitutes medical ethics, if used for teaching it needs to be balanced by other materials

The medical ethics of Dr J Marion Sims: a fresh look at the historical record

Wall, L L
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /06/2006 Português
Relevância na Pesquisa
66.11%
Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims's modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time.

Developing and Teaching the Virtue-Ethics Foundations of Healthcare Whistle Blowing

Faunce, Thomas
Fonte: Monash University Publicador: Monash University
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
56.27%
Healthcare whistle blowing, despite the benefits it has brought to healthcare systems in many developed countries, remains generally regarded as a pariah activity by many of the most influential healthcare professionals and regulatory institutions. Few if any medical schools or law department health law and bioethics classes, teach whistle blowing in a formal sense. Yet without exception, public inquiries initiated by healthcare whistle blowers have validated their central allegations and demonstrated that the whistle blowers themselves were sincere in their desire to implement the fundamental virtues and principles of medical ethics, bioethics and public health law. In many jurisdictions, the law, this time remarkably in advance of professional opinion, has offered legislative protection for reasonable allegations of whistleblowers made in good faith and in the public interest concerning a substantial and imminent threat to public safety. One reason for this paradoxical position, explored here, is that healthcare whistle blowing lacks a firm virtue-based theoretical bioethical and jurisprudential foundation. The hypothesis discussed is that the lack of this bioethical and jurisprudential substrate has contributed to a situation where healthcare whistle blowing suffers in terms of institutional support due to its lack of academic legitimacy. This article commences the process of redressing this imbalance by attempting to lay the theoretical foundations for healthcare whistle blowing. As a case study...

Flexners ethical oversight reprised? Contemporary medical education and the health impacts of corporate globalization

Faunce, Thomas; Gatenby, Paul
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
56.39%
BACKGROUND: Abraham Flexner's famous reports of 1910 and 1912, Medical Education in the United States and Canada and Medical Education in Europe, were written to assist the development of a positive response in university curricula to a revolution in understanding about the scientific foundations of clinical medicine. Flexner pointed out many deficiencies in medical education that retain contemporary resonance. Generally underemphasised in Flexner's reports, however, were recommendations promoting a firm understanding of and commitment to medical ethics as a basis of medical professionalism. Indeed, Flexner's praise for the scholastic basic of German medical education appeared somewhat ironic when the ethical inadequacies of prominent Nazi doctors were revealed at the Nuremberg Trials. CORPORATE GLOBALISATION AND ITS IMPACT ON MEDICAL PROFESSIONALISM: This article suggests that contemporary medical educators, like Flexner, may be at risk of inadequately addressing a major challenge to evolving medical professionalism. Medical ethics, health law and even the international right to health are now increasingly emphasised in medical curricula. The same cannot be said, however, of lobbying principles arising from the structures of corporate globalisation...

Dilemmas in Military Medical Ethics: A Call for Conceptual Clarity

Rochon, Christiane
Fonte: BioéthiqueOnline Publicador: BioéthiqueOnline
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
66.26%
Malgré l’augmentation des conflits armés et des changements qui les caractérisent, les enjeux éthiques auxquels font face les médecins militaires sont très peu traités dans la littérature en bioéthique. Les médecins militaires sont des membres du corps militaire, même s’ils sont non combattants, et ils jouent un rôle de soignant tout en pouvant être appelés à agir comme aide humanitaire. Certains auteurs se sont même interrogés sur la compatibilité morale d’être à la fois médecin et soldat. Les conflits éthiques soulevés dans la littérature sur les médecins militaires peuvent être organisés autour de trois perspectives : 1) les problèmes moraux en médecine militaire seraient particuliers compte tenu des difficultés à respecter les principes bioéthiques traditionnels; 2) les codes d’éthique médicaux et les lois internationales seraient trop restrictifs ou inadéquats pour le contexte militaire; et 3) les médecins sont des acteurs sociaux qui devraient être pacifistes, défenseurs des droits de la personne, politiquement neutres ou promoteurs de la paix. Une revue des divers dilemmes rencontrés par les médecins militaires identifiés dans la littérature nous montre que ces perspectives se situent à des niveaux d’analyse différents (micro...

Ética médica e bioética; Bioethics and medical ethics

Oliveira, Reinaldo Ayer de
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 07/11/2005 Português
Relevância na Pesquisa
66.16%
The expression medical ethics may be defined as what physicians usually say “to follow what is determined by the ethics code”: duties and rights of physicians”. Bioethics is an area of human knowledge which relates ethic values with biological facts mainly those facts which involve life and health of human beings within a proper environment.; A expressão ética médica pode ser definida como aquilo que os médicos tomaram por hábito denominar “o cumprimento ao determinado pelo código de ética: deveres e direitos dos médicos”. A bioética afirma-se como uma área do conhecimento humano que relaciona os valores éticos com fatos biológicos sobretudo aqueles fatos que envolvem a vida e a saúde do seres humanos dentro de um meio ambiente adequado.

The relationship between medical law and good medical ethics

Jackson, Emily
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Article; PeerReviewed Formato: application/pdf
Publicado em /01/2015 Português
Relevância na Pesquisa
56.27%
In the UK, medical ethics and law are often thought of and taught together, but while ‘good medical ethics’ is often reflected in law–the need to obtain a patient's adequately informed consent, for example—this is not necessarily the case. Sometimes medical ethics is more demanding than law; at other times, perhaps counterintuitively, the law appears to ask more of doctors than does good medical ethics.

Teaching of Medical Ethics: Students' perception in different periods of the course

PIMENTEL,DÉBORAH; BARBOSA DE OLIVEIRA,CARLA; VIEIRA,MARÍA JÉSIA
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 Português
Relevância na Pesquisa
56.33%
Background: Medical Ethics is structured to guide doctors towards a better professional practice. However, its teaching in medical schools seems to be neglected. Aim: To evalúate the perception of Federal University of Sergipe medical students about ethical conflicts duringtheir academic practice, in two different periods of a medical course. Material ana Methods: A cross-sectional, analytic and observatio-nal study. Using a qualitative approach, analytic categories were identified using an open questionnaire answered by two groups of students, before and after attending the medical ethics course. Results: In everyday practice, the participants referred embarrassment in front of patients. When considering the relationship with the professional/professor, they identified negligence and conflicts of interests in their practice. The students also detected bad infrastructure and professional relationship in public services, when compared to prívate ones. The conflicts experienced by the students in their own practice were insecurity, inability to cope with patients' problems and inadequate perception of medical confidentiality limits. According to the respondents, contribution of ethics teaching varied from adequate, when itwas effective to orient their practice and provide confidence...