This article describes three kinds of information constraints in medical encounters that have not been discussed at length in the medical ethics literature: constraints from the concept of a disease, from the diffusion of medical innovation, and from withholding information. It describes how these limit the reliance rational people can justifiably put in their doctors, and even the reliance doctors can have on their own advice. It notes the implications of these constraints for the value of informed consent, identifies several procedural steps that could increase the value of the latter and improve diffusion of innovation, and argues that recognition of these constraints should lead us to devise protections which intrude on but can improve these encounters.
{"title":"Information constraints in medical encounters.","authors":"R D Hollander","doi":"10.1007/BF01104001","DOIUrl":"https://doi.org/10.1007/BF01104001","url":null,"abstract":"<p><p>This article describes three kinds of information constraints in medical encounters that have not been discussed at length in the medical ethics literature: constraints from the concept of a disease, from the diffusion of medical innovation, and from withholding information. It describes how these limit the reliance rational people can justifiably put in their doctors, and even the reliance doctors can have on their own advice. It notes the implications of these constraints for the value of informed consent, identifies several procedural steps that could increase the value of the latter and improve diffusion of innovation, and argues that recognition of these constraints should lead us to devise protections which intrude on but can improve these encounters.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 2","pages":"116-26"},"PeriodicalIF":0.0,"publicationDate":"1984-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01104001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21142192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prevailing case study approach to teaching biomedical ethics is compared with a new methodology using short written exercises designed to develop decision making skills. Course content of this new approach and its adaptability to computer assisted instruction with student-faculty interactive software are outlined.
{"title":"A structured approach to teaching decision-making skills in biomedical ethics.","authors":"R T Francoeur","doi":"10.1007/BF01104003","DOIUrl":"https://doi.org/10.1007/BF01104003","url":null,"abstract":"<p><p>The prevailing case study approach to teaching biomedical ethics is compared with a new methodology using short written exercises designed to develop decision making skills. Course content of this new approach and its adaptability to computer assisted instruction with student-faculty interactive software are outlined.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 2","pages":"145-54"},"PeriodicalIF":0.0,"publicationDate":"1984-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01104003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21142195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Moral contracts and the patient-physician relationship.","authors":"D Rothbard","doi":"10.1007/BF01103647","DOIUrl":"https://doi.org/10.1007/BF01103647","url":null,"abstract":"","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"54-62"},"PeriodicalIF":0.0,"publicationDate":"1984-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01103647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21140614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Institutional Review Board is a committee of the institution responsible for carrying out the institution's responsibilities for the protection of human research subjects. Since it is a local committee, most of the complaints about the IRB can be resolved locally provided it is borne in mind that the IRB is the champion not only of the human research subject but also of the investigator. National or regional cooperative research protocols present problems that are not insurmountable.
{"title":"A commentary on Dr. Kennedy's perception of the impact of institutional review boards on cancer research.","authors":"H S Wigodsky","doi":"10.1007/BF01103645","DOIUrl":"https://doi.org/10.1007/BF01103645","url":null,"abstract":"<p><p>The Institutional Review Board is a committee of the institution responsible for carrying out the institution's responsibilities for the protection of human research subjects. Since it is a local committee, most of the complaints about the IRB can be resolved locally provided it is borne in mind that the IRB is the champion not only of the human research subject but also of the investigator. National or regional cooperative research protocols present problems that are not insurmountable.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"1984-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01103645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21140613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A purely deductive medical ethics cannot properly account for the varieties of circumstances which arise in medical practice. By contrast, a purely inductive medical ethics lacks sufficient guidance from ethical principles. In resolving ethical dilemmas in medicine, most often an appeal is made to middle-level axioms and methodological rules to mediate between theory and practice. I argue that this appeal must be augmented by considerations of context, such considerations, in effect, constituting a moral rule based on the social structure of medical practice. A contextual grid is proposed which assists the process of weighing values in resolving cases.
{"title":"The context as a moral rule in medical ethics.","authors":"D C Thomasma","doi":"10.1007/BF01103648","DOIUrl":"https://doi.org/10.1007/BF01103648","url":null,"abstract":"<p><p>A purely deductive medical ethics cannot properly account for the varieties of circumstances which arise in medical practice. By contrast, a purely inductive medical ethics lacks sufficient guidance from ethical principles. In resolving ethical dilemmas in medicine, most often an appeal is made to middle-level axioms and methodological rules to mediate between theory and practice. I argue that this appeal must be augmented by considerations of context, such considerations, in effect, constituting a moral rule based on the social structure of medical practice. A contextual grid is proposed which assists the process of weighing values in resolving cases.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"63-79"},"PeriodicalIF":0.0,"publicationDate":"1984-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01103648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21144748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The concepts of informed consent and surveillance of human research designed to protect human subjects is commendable. The regulations of the Institutional Review Board (IRB) are having a major impact on clinical cancer research. There is greater administrative time needed of the investigator, the mechanisms of patient care have become cumbersome and some patients reject optional medical management that could be life saving. IRB regulations must be flexible to meet the needs of human subjects as well as those of the clinical investigator.
{"title":"Impact of institutional review boards on cancer research.","authors":"B J Kennedy","doi":"10.1007/BF01103644","DOIUrl":"https://doi.org/10.1007/BF01103644","url":null,"abstract":"<p><p>The concepts of informed consent and surveillance of human research designed to protect human subjects is commendable. The regulations of the Institutional Review Board (IRB) are having a major impact on clinical cancer research. There is greater administrative time needed of the investigator, the mechanisms of patient care have become cumbersome and some patients reject optional medical management that could be life saving. IRB regulations must be flexible to meet the needs of human subjects as well as those of the clinical investigator.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"1984-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01103644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21140609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The authors review the implication of the term "professional," especially those dealing with the need for an ethic of trustworthiness and those dealing with the expectation of being paid for services. The erosive potential generated by these foci is explored, and circumstances which magnify or might ameliorate the potential described. The article concludes with a consideration of the relationship between professional ethics and world-view.
{"title":"Morals and money.","authors":"A G Burstein, W A Miller, R Warren","doi":"10.1007/BF01103646","DOIUrl":"https://doi.org/10.1007/BF01103646","url":null,"abstract":"<p><p>The authors review the implication of the term \"professional,\" especially those dealing with the need for an ethic of trustworthiness and those dealing with the expectation of being paid for services. The erosive potential generated by these foci is explored, and circumstances which magnify or might ameliorate the potential described. The article concludes with a consideration of the relationship between professional ethics and world-view.</p>","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"41-53"},"PeriodicalIF":0.0,"publicationDate":"1984-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01103646","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21140611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patents for life forms: An inappropriate response to biotechnological advancement","authors":"J. Densberger","doi":"10.1007/BF01104000","DOIUrl":"https://doi.org/10.1007/BF01104000","url":null,"abstract":"","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"91-115"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01104000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51393808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recommendations of the task force on privacy, human sexuality, and sex education for developmentally disabled persons","authors":"Robin Bohn","doi":"10.1007/bf01103643","DOIUrl":"https://doi.org/10.1007/bf01103643","url":null,"abstract":"","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"473 1","pages":"6-26"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/bf01103643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51385442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Selected books","authors":"Jeanne L. Lischer, A. M. Decoster","doi":"10.1007/BF01104004","DOIUrl":"https://doi.org/10.1007/BF01104004","url":null,"abstract":"","PeriodicalId":80021,"journal":{"name":"Journal of bioethics","volume":"5 1","pages":"155-159"},"PeriodicalIF":0.0,"publicationDate":"1984-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF01104004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51394422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}