Abstract:
OBJECTIVE:Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. DESIGN:We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. RESULTS:Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). CONCLUSIONS:This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Brauer SG,Yoon JD,Curlin FAdoi
10.1136/medethics-2015-102782subject
Has Abstractpub_date
2016-02-01 00:00:00pages
80-4issue
2eissn
0306-6800issn
1473-4257pii
medethics-2015-102782journal_volume
42pub_type
杂志文章abstract:OBJECTIVES:To evaluate the UK undergraduate medical ethics curricula against the Institute of Medical Ethics (IME) recommendations; to identify barriers to teaching and assessment of medical ethics and to evaluate perceptions of ethics faculties on the preparation of tomorrow's doctors for clinical practice. DESIGN:Qu...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103189
更新日期:2017-09-01 00:00:00
abstract::The author, a philosopher, suggests that the concept of death should be left as it is 'in its present indeterminate state', and that we ought to reject attempts to define death in terms of whole-brain death or any other type of brain death, including cerebral death and 'irreversible coma'. Instead of 'fiddling with th...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.9.1.28
更新日期:1983-03-01 00:00:00
abstract::We analyse the system of ethical review of human research in the Baltic States by introducing the principle of equivalent stringency of ethical review, that is, research projects imposing equal risks and inconveniences on research participants should be subjected to equally stringent review procedures. We examine seve...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2009.035030
更新日期:2010-07-01 00:00:00
abstract::In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant (mt.1555A>G) that increases the risk of deafness if a carrier is given the antibiotic gentamic...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2020-106807
更新日期:2021-02-01 00:00:00
abstract::Literary accounts of traumatic events can be more informative and insightful than personal testimonials. In particular, reference to works of literature can give us a more vivid sense of what it is like to receive a devastating diagnosis. In turn this can lead us to question some common assumptions about the nature of...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.24.2.123
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:There is little evidence of junior trainee perspectives in the design and implementation of medical ethics and law (MEL) curriculum in UK medical schools. AIM:To determine the ethical issues the foundation year 1 (FY1) doctors (first year after graduation) encountered during clinical practice and the skill...
journal_title:Journal of medical ethics
pub_type: 杂志文章,多中心研究
doi:10.1136/medethics-2011-100391
更新日期:2014-04-01 00:00:00
abstract::Ancell and Sinnott-Armstrong argue that medical providers possess wide freedoms to determine the scope of their practice, and therefore, prohibiting almost any conscientious objections is a bad idea. They maintain that we could create an acceptable system on the whole which even grants accommodations to discriminatory...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-105173
更新日期:2019-03-01 00:00:00
abstract::This is the first contribution to a new JME column, "At the coalface," to which readers are invited to relate ethical problems they have encountered in their work. An adolescent patient requested that the author, a general practitioner, certify that he was medically fit to box. Toon attempted to dissuade him from bo...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.14.2.69
更新日期:1988-06-01 00:00:00
abstract::Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2014-102026
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:This study aimed to determine the ability to successfully contact past paediatric patients and their families to request participation in research, to assess familial views on the use of previously collected archival clinical samples for research purposes, and to highlight the ethical and practical issues in...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103141
更新日期:2016-07-01 00:00:00
abstract::Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2017-104503
更新日期:2018-08-01 00:00:00
abstract::Several films, including Three Identical Strangers, examined ethical problems in an experiment that involved identical siblings who were adopted as infants and separated into different families to examine the effects of nature versus nurture. The study was primarily designed and directed by Dr Peter Neubauer. The expe...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2019-105983
更新日期:2020-05-04 00:00:00
abstract::In 2018 and 2019 Cancer Research UK (CRUK) launched a controversial advertising campaign to inform the British public of obesity being a preventable cause of cancer. On each occasion the advertisements used were emotive and provoked frustration among the British public which was widely vocalised on social media. As we...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2020-106192
更新日期:2020-11-25 00:00:00
abstract:INTRODUCTION:Future HIV vaccine efficacy trials with adolescents will need to ensure that participants comprehend study concepts in order to confer true informed assent. A Hepatitis B vaccine trial with adolescents offers valuable opportunity to test youth understanding of vaccine trial requirements in general. METHOD...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2012-101286
更新日期:2013-06-01 00:00:00
abstract::This article is a response to Raphael Cohen-Almagor's paper entitled 'First do no harm: intentionally shortening lives of patients without their explicit request in Belgium'. His paper deals with very important matters of life and death, however its concept usage is in part misleading. For instance, the fact that medi...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2015-103128
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK. DESIGN:Qualitative study using focus groups (10) and interviews (13). SETTING:England and Northern Ireland. PARTICIPANTS:68 peo...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2008.025304
更新日期:2009-02-01 00:00:00
abstract::Eduard Seidler sets his discussion of the teaching of medical ethics in the Federal Republic of Germany against an historical background. Immediately after the Second World War the freshness of the memory of the 'Nuremberg Medical Trials' influenced the way in which moral dilemmas were treated in Germany. At the prese...
journal_title:Journal of medical ethics
pub_type: 历史文章,杂志文章
doi:10.1136/jme.5.2.76
更新日期:1979-06-01 00:00:00
abstract::The 'right to the truth' involves disclosing all the pertinent facts to a patient so that an informed decision can be made. However, this concept of a 'right to the truth' entails certain ambiguities, especially since it is difficult to apply the concept in medical practice based mainly on current evidence-based data ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2009.033340
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:To compare 2005 and 1995 ethics guidelines from journal editors to authors regarding requirements for institutional review board (IRB) approval and conflict-of-interest (COI) disclosure. DESIGN:A descriptive study of the ethics guidelines published in 103 English-language biomedical journals listed in the A...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2008.024299
更新日期:2009-01-01 00:00:00
abstract::In contemporary medical ethics health is rarely acknowledged to be an ethical obligation. This oversight is due to the preoccupation of most bioethicists with a rationalist, contract model for ethics in which moral obligation is limited to truth-telling and promise-keeping. Such an ethics is poorly suited to medicine ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.10.3.138
更新日期:1984-09-01 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
abstract::The feasibility of a common European code of medical ethics is discussed, with consideration and evaluation of the difficulties such a project is going to face, from both the legal and ethical points of view. On the one hand, the analysis will underline the limits of a common European code of medical ethics as an inst...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-102963
更新日期:2017-01-01 00:00:00
abstract::I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting (at least) those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; miti...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-104761
更新日期:2019-02-01 00:00:00
abstract::Recently, new developments took place in the Dutch debate on the legislation of euthanasia. After a brief account of that debate, the article discusses a new government proposal for legislation in this field, which was submitted to the Dutch parliament in November 1991. This proposal relates not only to euthanasia but...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.18.3.138
更新日期:1992-09-01 00:00:00
abstract::The International Bioethics Committee (IBC) of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) is currently drafting a Universal Bioethics Declaration ("the declaration"). The content and even the name of the declaration has yet to be finalized, but it is expected to range widely over hum...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2004.006502
更新日期:2005-03-01 00:00:00
abstract::This opinion piece aims to situate the placebo effect within the field of psychiatric treatment. To accomplish this, the placebo is explored at the centre of an often heated debate between three discrete perspectives: the clinical trial researcher, the placebo researcher and the clinician. Each occupational perspectiv...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101410
更新日期:2014-06-01 00:00:00
abstract::Kovacs argues that honorary authorship and regarding each co-author of multi-authored papers as if they were sole authors when the performance of researchers is being evaluated by their publications mean that we should require authors to identify what proportion of each publication should be attributed to each co-auth...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2012-100939
更新日期:2013-08-01 00:00:00
abstract::This point of view compares the issue of informed patient consent primarily as it operates in Australia and the United Kingdom. It affords an overview, also, of the applicable law in the United States and Canada. It particularly focuses on the legal test to be applied to patient consent as established in the Bolam cas...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.21.1.5
更新日期:1995-02-01 00:00:00
abstract::Since Bennett, Draper, and Frith published a paper in this journal in 2000 considering the possible criminalisation of HIV transmission, an important legal development has taken place. February 2001 saw the first successful United Kingdom prosecution for the sexual transmission of disease for over a century, when Step...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.28.3.160
更新日期:2002-06-01 00:00:00
abstract::The realm of non-rational influence, which includes nudging, is home to many other morally interesting phenomena. In this paper, I introduce the term bumping, to discuss the category of unintentional non-rational influence. Bumping happens constantly, wherever people make choices in environments where they are affecte...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-105179
更新日期:2019-04-01 00:00:00