Clinical & Medical Ethics

Clinical Ethics Dilemmas: How Does the Doctor Decide Between Cost and Care?

Should a pediatrician use a less expensive and well-established vaccination product with adequate reimbursement rather than a newer, more expensive version with better bacterial protection that has a lower profit margin?

Podcast Episode: 
169

Adolescent Confidentiality: An Uneasy Truce

How should a physician respond to multiple-party claims of authority?

Podcast Episode: 
163

Doing No Harm To Hippocrates: Reality and Virtual Reality in Ethics Education

On July 23, 1944, Nazi officers ordered the entire Jewish population of Kos to leave their homes and, along with the Jewish population of nearby Rhodes, to board three small cargo boats. Stripped of their personal belongings and identity papers, these families were taken on an eight day voyage by sea to Piraeus, and from there, crowded into cattle cars, North by train for the 13 day journey to their final destination at Auschwitz. Such was the fate of many Jewish men, women and children throughout the Nazi-occupied territories in Europe, who were forcibly exiled and sent to their deaths.

Podcast Episode: 
162

Commentary: Six Years Later and Katrina Still Engenders Bioethical Debate

During August 2005, the Gulf Coast experienced the most expensive natural disaster in history. The remarkable devastation would be painfully remembered simply as Hurricane Katrina. Amidst the hue and cry of lives lost, levees that failed—and alleged FEMA incompetence—Hurricane Katrina’s darkest moments, especially for medicine, continue to reverberate. It must never be forgotten that after the initial shock from the powerful storm had dissipated, forty-five corpses were retrieved from one New Orleans hospital under suspicious circumstances.[1] A subsequent article reporting the events was trenchant enough to receive a Pulitzer Prize.[2] At the time, it was alleged that some of these forty-five individuals were injected with sedatives such as morphine to relieve either their suffering or to deliberately hasten their deaths.[3] Therein lays the rub of the principle of double effect. The Louisiana Attorney General and prominent forensic scientists labeled what happened homicide.[4] The local coroner later testified in agreement with this claim and provided evidence of the drug levels to demonstrate what should have been a lethal cause and effect. Also critical to the ensuing debate, several of these persons whose death may have been hastened did not have a Do Not Resuscitate order. There was no evidence that any of the individuals consented to assisted suicide. One case study may provide insight.[5]

Podcast Episode: 
165

End-of-Life Care in the Long-Term Cancer Survivor

How should the family and the medical team proceed with medical care when there is conflict over treatment options in a long-term cancer survivor in the absence of clear surrogacy?

Podcast Episode: 
158

Taking Another Stab: Rethinking the Killing vs. Letting Die Distinction for the Euthanasia Debate

Some bioethicists think that if the distinction is not maintained in and of itself and by itself that it opens the door for the moral permissibility of physician-assisted suicide and euthanasia. The presenter argues that this is not necessarily the case. Furthermore, he maintains that there is and ought to remain a strong prima facie prohibition against killing, and that these claims are consistent with an evangelical approach to Christian theology. 

Podcast Episode: 
156

Enhanced Dying: Exploring the Dangers of Palliative Care Moving Beyond Therapy

his presentation will address how changing definitions of death, institutionalization of death, dualistic anthropology, and this new responsibility of medicine can encourage care beyond therapy to intentional sedation and assisted death. Corrected definitions and processes will be offered that will encourage responsible care of patients without violating accepted ethical standards.

Podcast Episode: 
155

The Changing Conscience of Healthcare: Vows vs. Laws in the Anatomy of a Profession

This paper considers the concept of conscience from an individual as well as a corporate perspective, examining both what it is and what it is not. It will consider the impact that changes in our healthcare system, particularly the regulation of moral determinations and the ways in which such regulations alter the object of professional obligations, will have on the concept of medicine as a profession.

Podcast Episode: 
153

The Need to Know: Disclosure of Information to Pediatric Patients

Should a nine-year old patient be told about her terminal medical condition?

Podcast Episode: 
152

Forced Sterilization of Native Americans: Late Twentieth Century Physician Cooperation with National Eugenic Policies

The protracted policy directed against the United States of America’s indigenous peoples represented misguided governments, widespread greed, and enforcement by an at times ruthless, undisciplined military. A recent, albeit weakly publicized, continuation of this policy has been played out in a bioethical arena. Indeed, after the Nuremberg Trials and an explicit international consensus, this would be considered anathema. On view is the evil of forced abortions and sterilizations. This two-pronged approach to knowingly limit births in selected populations was emblematic of eugenic policy in the early to mid-twentieth century. Unfortunately, eugenic birth control had been resuscitated as late as the 1970s through voluntary physician complicity with an immoral national eugenic policy.

Podcast Episode: 
149

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