The inescapable relevance of bioethics for the practicing clinician.


KEY POINTS:1. Historically, medical ethics focused on the proper conduct of physicians as members of a profession. 2. Bioethics has emerged as a distinct field over the past several decades and has a broader scope than traditional medical ethics. The field of bioethics includes research ethics, public health ethics, organizational ethics, and clinical ethics. 3. Several factors contributed to the emergence of bioethics, helping to shape it, including the following: abuses of human subjects in research; advances in medical therapeutics and medical technology; and complex societal changes. 4. Principlism is an important approach to ethics, and in bioethics it includes the following core principles: respect for autonomy; beneficence; nonmaleficence; and justice. 5. Clinical ethics is a major part of bioethics and is concerned with ethical issues encountered in the care of patients. 6. Clinicians should recognize that every interaction between a doctor and a patient has a moral component, and that competency in bioethics is required to competently practice medicine. 7. Deficiencies exist in bioethics knowledge and performance among practicing clinicians and trainees; therefore, bioethics education is needed for learners at all levels (i.e., medical students, trainees, and practicing clinicians). 8. Bioethics is a dynamic, multidisciplinary field with several dedicated journals, a national organization, and numerous centers and institutes. 9. Important scholarly work in bioethics, both empirical and conceptual, is being conducted and disseminated, providing important information for practicing clinicians.






Carrese JA,Sugarman J




Has Abstract


2006-12-01 00:00:00
















  • Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis.

    abstract:BACKGROUND:Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of interferon (IFN)-gamma measurements in pleural fluid for the early diagnosis of tuberculous pleurisy. We conducted a metaanalysis to determine the accuracy of IFN-gamma me...


    pub_type: 杂志文章,meta分析,评审


    authors: Jiang J,Shi HZ,Liang QL,Qin SM,Qin XJ

    更新日期:2007-04-01 00:00:00

  • Persistent pulmonary granulomas after recovery from varicella pneumonia.

    abstract::A 41-year-old man was found to have a miliary infiltrate on chest roentgenogram two months after recovery from varicella pneumonia. The patient remained in good health and there was no objective sign of pulmonary disease. The infiltrate showed no change in subsequent serial chest films, and after one year, open lung b...


    pub_type: 杂志文章


    authors: Meyer B,Stalder H,Wegmann W

    更新日期:1986-03-01 00:00:00

  • Socioeconomic status and lung function.

    abstract::Poverty is a major social problem in the United States and throughout much of the world. Poverty and the broader term socioeconomic status (SES) are important determinants of overall health status and many pulmonary diseases. The purpose of this study was to review the medical literature from the past 20 years address...


    pub_type: 杂志文章,评审


    authors: Hegewald MJ,Crapo RO

    更新日期:2007-11-01 00:00:00

  • Nonsurgical treatment of Histoplasma endocarditis involving a bioprosthetic valve.

    abstract::Endocardial involvement associated with disseminated histoplasmosis has been infrequently documented, especially among patients with prosthetic valves. The therapeutic approach to these patients is also not yet clearly defined. A 54-year-old man with prosthetic valve endocarditis due to histoplasmosis was successfully...


    pub_type: 杂志文章,评审


    authors: Kanawaty DS,Stalker MJ,Munt PW

    更新日期:1991-01-01 00:00:00

  • Postinfarctional ventricular septal rupture. Clinical approach and surgical results.

    abstract::This study represents an analysis of 13 cases of ruptured interventricular septum occurring as a complication of myocardial infarction. The cases considered appeared to divide themselves into two groups. One group survived the septal rupture for weeks or months and underwent surgery in the chronic stage. The patients ...


    pub_type: 杂志文章


    authors: Kaplan MA,Harris CN,Kay JH,Parker DP,Magidson O

    更新日期:1976-06-01 00:00:00

  • Relationship of resting lung mechanics and exercise pattern of breathing in patients with chronic obstructive lung disease.

    abstract::To investigate the influence of resting pulmonary mechanics on the pattern of breathing during exercise in chronic obstructive pulmonary disease (COPD), we studied 29 patients with moderate to severe COPD (FEV1 50 +/- 20 percent predicted), and 10 normal subjects. Lung mechanics were studied using esophageal balloon t...


    pub_type: 杂志文章


    authors: Marin JM,Hussain SN,Gibbons WJ,Polverino M,Levy RD,Cosio MG

    更新日期:1993-09-01 00:00:00

  • Periodic limb movements during sleep in patients with congestive heart failure.

    abstract::The prevalence of periodic limb movements (PLM) during sleep and their effect on sleep and daytime alertness were determined in 23 men with severe, stable congestive heart failure (CHF) and 9 healthy control subjects. Each subject had overnight polysomnography and the following day completed a subjective assessment of...


    pub_type: 杂志文章


    authors: Hanly PJ,Zuberi-Khokhar N

    更新日期:1996-06-01 00:00:00

  • Intra- and interobserver variations in the measurement of systolic time intervals.

    abstract::Intra- and interobserver variations in the measurement of systolic time intervals (STIs) by three experienced cardiologists were investigated in 20 tracings on which phonocardiograms, carotid pulse and electrocardiograms were recorded simultaneously. The STIs studied were the time interval from the Q wave to the aorti...


    pub_type: 杂志文章


    authors: Ishikawa K,Ishikawa M,Morihara H,Yanagisawa A,Muramatsu J,Sawayama T,Maeda K

    更新日期:1982-03-01 00:00:00

  • Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust.

    abstract:BACKGROUND:The World Trade Center (WTC) collapse on September 11, 2001, produced airflow obstruction in a majority of firefighters receiving subspecialty pulmonary evaluation (SPE) within 6.5 years post-September 11, 2001. METHODS:In a cohort of 801 never smokers with normal pre-September 11, 2001, FEV1, we correlated...


    pub_type: 杂志文章


    authors: Nolan A,Naveed B,Comfort AL,Ferrier N,Hall CB,Kwon S,Kasturiarachchi KJ,Cohen HW,Zeig-Owens R,Glaser MS,Webber MP,Aldrich TK,Rom WN,Kelly K,Prezant DJ,Weiden MD

    更新日期:2012-08-01 00:00:00

  • Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy.

    abstract:BACKGROUND:There remains debate over the best invasive diagnostic modality for mediastinal nodal evaluation. Prior studies have limited generalizability and insufficient power to detect differences in rare adverse events. We compared the risks and costs of endobronchial ultrasound (EBUS)-guided nodal aspiration and med...


    pub_type: 杂志文章


    authors: Verdial FC,Berfield KS,Wood DE,Mulligan MS,Roth JA,Francis DO,Farjah F

    更新日期:2020-03-01 00:00:00

  • Impact of a hospital-based home-care program on the management of COPD patients receiving long-term oxygen therapy.

    abstract:STUDY OBJECTIVES:To analyze the influence of a hospital-based home-care program (HCP) on the management of patients with COPD receiving long-term oxygen therapy. DESIGN AND SETTING:Randomized, controlled study in a 1,000-bed university hospital. INTERVENTION:The HCP applied to patients in the intervention group (HCP ...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Farrero E,Escarrabill J,Prats E,Maderal M,Manresa F

    更新日期:2001-02-01 00:00:00

  • Comparison of 24 versus 12 hours of ambulatory ECG monitoring.

    abstract::In order to assess the additional information obtained from 24 hours compared to 12 hours of ambulatory ECG (electrocardiogram) recording, we analyzed 72 ambulatory ECG monitoring tapes in which arrhythmias were present. In all cases the second 12 hours included the entire period of sleep. Only 38 of 233 (16 percent) ...


    pub_type: 杂志文章


    authors: Lopes MG,Runge P,Harrison DC,Schroeder JS

    更新日期:1975-03-01 00:00:00

  • Defensive role of pleural mesothelial cell sialomucins in tumor metastasis.

    abstract:STUDY OBJECTIVES:Sialomucin complex (SMC) is a heterodimeric glycoprotein, and is found on the surfaces of the mesothelia of the pleura, pericardium, and peritoneum. Sialomucins play a significant role in adhesion as well as in defense. In this study, we hypothesized that pleural mesothelial cells (PMCs) express SMC an...


    pub_type: 杂志文章


    authors: Sharma RK,Mohammed KA,Nasreen N,Hardwick J,Van Horn RD,Ramirez-Icaza C,Antony VB

    更新日期:2003-08-01 00:00:00

  • Cytomegalovirus infection with idiopathic pulmonary fibrosis. Diagnosis suggested by bronchoalveolar lavage.

    abstract::Bronchoalveolar lavage was used to provide important diagnostic information for a patient found to have idiopathic pulmonary fibrosis and concomitant cytomegalovirus infection. The use of this procedure may not only provide useful information regarding the underlying disease, but may also suggest alternative diagnosti...


    pub_type: 杂志文章


    authors: Martin WJ 2nd,McDougall JC

    更新日期:1983-10-01 00:00:00

  • Inclusion criteria for clinical trials in sepsis: did the American College of Chest Physicians/Society of Critical Care Medicine consensus conference definitions of sepsis have an impact?

    abstract:BACKGROUND:Over the last 25 years, a growing number of clinical trials have evaluated novel sepsis therapies. To promote uniformity in inclusion criteria for patient enrollment, the American College of Chest Physicians and Society of Critical Care Medicine first published consensus conference definitions for sepsis in ...


    pub_type: 杂志文章


    authors: Trzeciak S,Zanotti-Cavazzoni S,Parrillo JE,Dellinger RP

    更新日期:2005-01-01 00:00:00

  • Respiratory infection complicating long-term tracheostomy. The implication of persistent gram-negative tracheobronchial colonization.

    abstract::Colonization of the lower respiratory tract by enteric Gram-negative bacilli (EGNB) has been a frequent finding in patients with long-term tracheostomies; however, the association of hospitalization and certain features of serious illness with this phenomenon has not been clearly established. Because such factors can ...


    pub_type: 杂志文章


    authors: Niederman MS,Ferranti RD,Zeigler A,Merrill WW,Reynolds HY

    更新日期:1984-01-01 00:00:00

  • Increased levels of outdoor air pollutants are associated with reduced bronchodilation in children with asthma.

    abstract:BACKGROUND:Increased outdoor air pollution levels are associated with more frequent use of rescue inhalers in subjects with asthma. However, it is unknown whether this phenomenon is explained by an air pollution-mediated increase in respiratory symptom severity or whether air pollutants decrease the efficacy of short-a...


    pub_type: 杂志文章


    authors: Hernández-Cadena L,Holguin F,Barraza-Villarreal A,Del Río-Navarro BE,Sienra-Monge JJ,Romieu I

    更新日期:2009-12-01 00:00:00

  • Clinical complexity and epidemiologic uncertainty in case-control research. Fenoterol and asthma management.

    abstract::Two recent epidemiologic case-control studies suggested that fenoterol, a selective beta-adrenergic agonist, was associated with an increase in the risk of asthma death. The results of these studies were criticized because of methodologic problems in the choice and selection of control subjects; the different methods ...


    pub_type: 杂志文章


    authors: Horwitz RI,Spitzer W,Buist S,Cockcroft D,Ernst P,Habbick B,Hemmelgarn B,McNutt M,Rebuck AS,Suissa S

    更新日期:1991-12-01 00:00:00

  • High-resolution CT findings of parenchymal fibrosis correlate with prognosis in hypersensitivity pneumonitis.

    abstract:BACKGROUND:Histopathologic evidence of fibrosis on surgical lung biopsy has been associated with reduced survival in patients with hypersensitivity pneumonitis (HP). Changes of pulmonary fibrosis detected on CT may also correlate with prognosis in patients with HP. METHODS:We identified 69 consecutive patients with HP...


    pub_type: 杂志文章


    authors: Hanak V,Golbin JM,Hartman TE,Ryu JH

    更新日期:2008-07-01 00:00:00

  • Cough and wheezing from beclomethasone aerosol.

    abstract::Cough and wheezing are frequent side effects of inhaling beclomethasone dipropionate aerosol (BA) in patients with asthma. Twenty percent of our outpatient asthmatic subjects are unable to take BA due to these side effects. Twelve patients with history of severe cough and wheezing after inhaling BA were tested. Three ...


    pub_type: 临床试验,杂志文章


    authors: Shim C,Williams MH Jr

    更新日期:1987-02-01 00:00:00

  • Pleural fluid neuron-specific enolase. A useful diagnostic marker for small cell lung cancer pleurisy.

    abstract::We studied the value of pleural fluid neuron-specific enolase as a possible diagnostic marker for pleurisy of small cell lung cancer by using enzyme immunoassay. Pleural fluid NSE levels in 12 patients with carcinomatous pleurisy due to small cell lung cancer were compared with those in 37 patients with carcinomatous ...


    pub_type: 杂志文章


    authors: Shimokata K,Niwa Y,Yamamoto M,Sasou H,Morishita M

    更新日期:1989-03-01 00:00:00

  • The effect of cigarette smoke exposure on pulmonary metastatic disease in a murine model of metastatic breast cancer.

    abstract:INTRODUCTION:Women who smoke have a higher rate of fatal breast cancer than nonsmoking women. An association between smoking and pulmonary metastases from breast cancer has been suggested by epidemiologic studies. STUDY OBJECTIVES:To examine the relationship between exposure to cigarette smoke and pulmonary metastasis...


    pub_type: 杂志文章


    authors: Murin S,Pinkerton KE,Hubbard NE,Erickson K

    更新日期:2004-04-01 00:00:00

  • Prolonged endurance challenge at moderate altitude: effect on serum eosinophil cationic protein, eosinophil dynamics, and lung function.

    abstract:BACKGROUND:Eosinophils contain granule proteins such as eosinophil cationic protein (ECP) that have proinflammatory effects on airways. ECP may be released on activation of eosinophils into the plasma and is widely used as a marker of bronchial hyperreactivity and allergic inflammation. Environmental factors as well as...


    pub_type: 杂志文章


    authors: Domej W,Schwaberger G,Tilz GP,Földes-Papp Z,Demel U,Lang J,von Duvillard SP

    更新日期:2002-04-01 00:00:00

  • Continuous lateral rotational therapy and nosocomial pneumonia.

    abstract::The adverse effects of prolonged immobility are due primarily to gravitational effects on blood flow and ventilation, impairment of the normal mucociliary escalator and possibly an increase in extravascular lung water. However, CLRT theoretically should reverse these abnormalities. The sequence of events that culminat...


    pub_type: 临床试验,杂志文章,随机对照试验,评审


    authors: Sahn SA

    更新日期:1991-05-01 00:00:00

  • The controversy of combination vs monotherapy in the treatment of hospitalized community-acquired pneumonia.

    abstract:BACKGROUND:The majority of community-acquired pneumonia (CAP) patients (about 80%) will be treated as outpatients, because therapy with a single agent will work. For the remaining 20% of patients requiring hospitalization, there is some growing debate regarding the efficacy of different management approaches. For hospi...


    pub_type: 杂志文章,评审


    authors: Weiss K,Tillotson GS

    更新日期:2005-08-01 00:00:00

  • Targeted Fluid Minimization Following Initial Resuscitation in Septic Shock: A Pilot Study.

    abstract:BACKGROUND:IV fluid represents a basic therapeutic intervention for septic shock. Unfortunately, the optimal administration of IV fluid to maximize patient outcomes and prevent complications is largely unknown. METHODS:Patients with septic shock admitted to the medical ICUs of Barnes-Jewish Hospital (January to Decemb...


    pub_type: 杂志文章,随机对照试验


    authors: Chen C,Kollef MH

    更新日期:2015-12-01 00:00:00

  • Transesophageal echocardiographic diagnosis of anomalous left coronary artery from the right aortic sinus.

    abstract::Patients with anomalous left main coronary artery arising from the right sinus of Valsalva and coursing posteriorly between the aorta and the pulmonary artery are prone to sudden death. We present a patient with this entity in whom the diagnosis was made by transesophageal two-dimensional echocardiography and coronary...


    pub_type: 杂志文章


    authors: Alam M,Brymer J,Smith S

    更新日期:1993-05-01 00:00:00

  • Closure of a ventricular septal defect through the aortic valve: a note of caution regarding resultant narrowing of the aortic valve annulus.

    abstract::Closure of ventricular septal defects through the aortic valve annulus has been described for a variety of cardiac anomalies. This technique is most appropriate when simultaneous aortic valve replacement is anticipated. A continuous suture through the patch material may produce a purse-string effect upon the aortic va...


    pub_type: 杂志文章


    authors: Stewart S

    更新日期:1976-08-01 00:00:00

  • Acute pulmonary effects of nitrogen dioxide exposure during exercise in competitive athletes.

    abstract::The acute pulmonary responses of athletes after short-term exposure to ambient concentrations of NO2 during heavy exercise have been examined. Intercollegiate male athletes were screened for history of cardiac disease, respiratory disease, allergic conditions and extensive exposure to pollutants. After completion of s...


    pub_type: 杂志文章


    authors: Kim SU,Koenig JQ,Pierson WE,Hanley QS

    更新日期:1991-04-01 00:00:00

  • Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases.

    abstract::A retrospective study was conducted in 23 subjects with previous occupational exposure to asbestos and exhibiting rounded atelectasis (RA) on high-resolution computed tomography scan (HRCT scan) to evaluate the retention of asbestos bodies (ABs) using light microscopy in the bronchoalveolar lavage (BAL) fluid or lung ...


    pub_type: 杂志文章


    authors: Voisin C,Fisekci F,Voisin-Saltiel S,Ameille J,Brochard P,Pairon JC

    更新日期:1995-02-01 00:00:00