Abstract:
:The urgency of the resuscitation and the impaired ability of the patient to make a reasonable autonomous decision both conspire against adequate consideration of the principles of medical ethics. Informed consent is usually not possible for these reasons and this leads many to consider that consent is not required for resuscitation, because resuscitation brings benefit and prevents harm and because the patient is not in a position to give or withhold consent. However, consent for resuscitation is required and the common models employed for this purpose are presumed consent or consent from a patient proxy. However, if we are to honour the principles of respect for patient autonomy, as well as beneficence and non-maleficence, when starting and continuing resuscitation we must try and achieve the best balance between benefit and harm from the patient's perspective. The concept of professional substituted judgment involves the resuscitators gathering as much information about the patient as they possibly can, including any previously expressed attitudes towards such a situation, and combining this with their acquired professional knowledge of the likely benefits and harms of the resuscitation endeavour and then exercising their moral imagination, imagining themselves as the patient, and asking "would I want this treatment?" By employing professional substituted judgment resuscitators should recognise when the balance of benefit and harm becomes unfavourable from the patient's perspective and at this point they have a moral obligation to withdraw resuscitation as they can no longer presume the patient's consent. In this way the principles of beneficence, non-maleficence and respect for patient autonomy are more favourably balanced than under other resuscitation decision making processes.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Ardagh Mdoi
10.1136/jme.25.5.375keywords:
subject
Has Abstractpub_date
1999-10-01 00:00:00pages
375-8issue
5eissn
0306-6800issn
1473-4257journal_volume
25pub_type
杂志文章abstract::Recognising that offers of payment to research participants can serve various purposes-reimbursement, compensation and incentive-helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need dif...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-105140
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:Potentially life-shortening medical end-of-life practices (end-of-life decisions (ELDs)) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices (described according to the precise act, the intention, the presence of an expli...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101854
更新日期:2014-07-01 00:00:00
abstract::Genetic parenthood is usually portrayed as a value-neutral concept that can be confirmed or rejected based on objective, scientific tests. However, on inspection, it is exposed as a very complex idea that we might need to consider as something that comes in different shapes and forms and that is open to interpretation...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101830
更新日期:2014-11-01 00:00:00
abstract::This paper investigates the medical law and ethics (MEL) learning needs of Foundation doctors (FYs) by means of a national survey developed in association with key stakeholders including the General Medical Council and Health Education England. Four hundred sevnty-nine doctors completed the survey. The average self-re...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2019-105961
更新日期:2020-04-10 00:00:00
abstract::It is a common feature of debates on the regulation of reproductive medicine to find law portrayed as a crude form of intervention consisting in the imposition of inflexible rules on doctors and medical researchers. This paper argues that this view must be replaced by a more accurate assessment of the law's potential ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.16.1.35
更新日期:1990-03-01 00:00:00
abstract::The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trial...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2017-104282
更新日期:2018-09-01 00:00:00
abstract::As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall f...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2017-104488
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To study the preferences of patients for information related to elective procedures. METHODS:A survey was carried out using a sample of 187 women. The majority of whom were on a low-income, who obtained obstetric or gynaecological services at St Joseph Regional Medical Center in Milwaukee, Wisconsin, while t...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2005.014274
更新日期:2006-08-01 00:00:00
abstract::The public often believes that parents have a right to make medical decisions about their child. The idea that, in respect of children, doctors should do what parents tell them to do is problematic on the face of it. The effect of such a claim would be that a doctor who acted deliberately to harm a child would be maki...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/medethics-2017-104705
更新日期:2018-07-01 00:00:00
abstract::Opioid and sedative use are common 'active' practices in the provision of mainstream palliative care services, and are typically distinguished from euthanasia on the basis that they do not shorten survival time. Even supposing that they did, it is often argued that they are justified and distinguished from euthanasia ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-105074
更新日期:2019-02-01 00:00:00
abstract::Non-therapeutic circumcision violates boys' right to bodily integrity as well as to self-determination. There is neither any verifiable medical advantage connected with the intervention nor is it painless nor without significant risks. Possible negative consequences for the psychosexual development of circumcised boys...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2012-101284
更新日期:2013-07-01 00:00:00
abstract::In this issue of the journal Mark Brown has offered a new argument against my potential future of value theory. I argue that even though the premises of this new argument are far more defensible than the premises of his old argument, the new argument does not show that the potential future of value theory of the wrong...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.28.3.198
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:There is little research into medical students' or doctors' attitudes to abortion, yet knowing this is important, as policy makers should be aware of the views held by professionals directly involved in abortion provision and changing views may have practical implications for the provision of abortion in the...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2007.023416
更新日期:2008-11-01 00:00:00
abstract::This paper relates two experiences of teaching medical ethics, the first to a small group of clinical medical students, the second to a larger group of GP trainees. :Boyd, a theologian who is Scottish Director of the Institute of Medical Ethics, comments on a day he spent teaching two ethics sessions, one to a group ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.13.3.132
更新日期:1987-09-01 00:00:00
abstract::With the increase in the proportion of hospital deaths there is increasing debate about appropriateness of place of death. Death should be a family affair but is increasingly hidden from public view. In contrast to those who die at home, most of those who die in hospital die alone with no relatives or friends with the...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.9.3.158
更新日期:1983-09-01 00:00:00
abstract::Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherit...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2011-100369
更新日期:2013-10-01 00:00:00
abstract::It is argued that the current policy of the British Medical Association (BMA) on conscientious objection is not aligned with recent human rights developments. These grant a right to conscientious objection to doctors in many more circumstances than the very few recognised by the BMA. However, this wide-ranging right m...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103222
更新日期:2017-04-01 00:00:00
abstract::The two tragedies argument (2TA) has been raised as a response to the argument against abortion from spontaneous abortion (or miscarriages). According to this argument against the antiabortion position (AAP), miscarriages should be of great concern for proponents of this position since they result in a greater amount ...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2019-105770
更新日期:2020-03-01 00:00:00
abstract:CONTEXT:The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality. OBJECTIVE:To identify and describe patient views of...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2004.010280
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2010.039255
更新日期:2011-06-01 00:00:00
abstract::Gabriele Badano offers three criticisms of my challenge to the orthodox family of theories of legitimacy in bioethics. First, I assumed an 'oversimplified version of the orthodoxy'. Second, I failed to appreciate its domain of application. Third, I only addressed the ways in which orthodox theorists incorporate substa...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2018-105030
更新日期:2019-04-01 00:00:00
abstract::The concept of evidence-based medicine (EBM) has been invented by physicians mostly from English Canada, mostly from McMaster University, Ontario, Canada. The term EBM first appeared in the biomedical literature in 1991 in an article written by a prominent member of this group-Gordon Guyatt from McMaster University. T...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2010.039735
更新日期:2011-03-01 00:00:00
abstract::Direct-to-consumer genetic testing is a growing phenomenon, fuelled by the notion that knowledge equals control. One ethical question that arises concerns the proband's duty to share information indicating genetic risks in their relatives. However, such duties are unenforceable and may result in the realisation of ant...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2020-106966
更新日期:2020-12-09 00:00:00
abstract::In this paper, I explore under what circumstances it might be morally acceptable to transplant organs from a patient lacking capacity. I argue, with a developed hypothetical based around a mother and son, that (1) 'Best interests' should be interpreted broadly to include the interests that people have previously expre...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103045
更新日期:2017-07-01 00:00:00
abstract::Many patients believe that cardiopulmonary resuscitation (CPR) is more likely to be successful than it really is in clinical practice. Even when working with accurate information, some nevertheless remain resolute in demanding maximal treatment. They maintain that even if survival after cardiac arrest with CPR is extr...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2019-105558
更新日期:2020-02-01 00:00:00
abstract::More than 25 years into the HIV epidemic, in excess of 2 million new infections continue to occur each year. HIV prevention research is crucial for groups at heightened risk for HIV, but the design and conduct of HIV prevention research with vulnerable populations worldwide raises considerable ethical challenge...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2010.035444
更新日期:2010-12-01 00:00:00
abstract::This paper is not about the medical condition of AIDS. Nor is it about the history of the condition since it was first reported in Atlanta, Georgia in 1981. It looks rather, at the catalogue of legislative and other legal responses to the spread of AIDS. The paper analyses the AIDS condition in its historical context....
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.12.4.187
更新日期:1986-12-01 00:00:00
abstract::This is a continuation of and a development of a debate between John Keown and me. The issue discussed is whether, in Britain, an unpaid system of blood donation promotes and is justified by its promotion of altruism. Doubt is cast on the notions that public policies can, and, if they can, that they should, be aimed a...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.25.6.532
更新日期:1999-12-01 00:00:00
abstract::Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression an...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/jme.14.1.18
更新日期:1988-03-01 00:00:00
abstract::The traditional view that having a personality disorder, unlike other mental disorders, is not usually reason enough to consider a person incompetent to make healthcare decisions is challenged. The example of a case in which a woman was treated for a physical disorder without her consent illustrates that personality d...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2007.023341
更新日期:2008-10-01 00:00:00