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A nursing home's good faith duty "to" care: redefining a fragile relationship using the law of contract. 养老院的善意义务:用合同法重新定义脆弱的关系。
Pub Date : 1994-01-01
M Armour
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引用次数: 0
The right to health care, the social contract, and health reform in the United States. 美国的医疗保健权、社会契约和医疗改革。
Pub Date : 1994-01-01
C Cassel
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引用次数: 0
Human experimentation and human rights. 人体实验和人权。
Pub Date : 1993-01-01 DOI: 10.4324/9781315198231-13
J. Katz
ion of the research question tends to objectify the person-patient.27 It does so to a significantly greater extent than in therapeutic interactions, even though similar problems of objectification arise in therapeutic settings when doctors attend too much to the disease of the body in the bed and not to the person before them. The readiness with which clinical research continues to be viewed as an extension of clinical practice, both similarly grounded in the millennia-long Hippocratic commitment to the welfare of the individual patient, overlooks the transformation of medical practice since the age of medical science. Throughout most of medical history, research was limited to careful bedside observation of the effects of innovative treatments, with the interests of the individual patient as a polestar. In today's world, on the other hand, the interests of patient-subjects may yield to varying extents to the interests of science. This revolutionary development has not been accompanied by a thoroughgoing re-examination of physicians' ethical obligations in a postHippocratic age. Examples in point are the many cooperative clinical trials, generally randomized clinical trials (RCTs),30 in which institutions throughout the 27. See infra note 66 and accompanying text. 28. In a conversation between a senior physician and a medical intern, the former asked how much the intern knew about "patients as human beings." The question led to a rather nonproductive exchange which the intern ended abruptly with the exasperated comment: "I cannot answer your questions. You're interested in patients. I'm interested in the disease in the body in the bed." RAYMOND S. DUFF & AUGUST B. HOLLINGSHEAD, SICKNESS AND SOCIETY 128 (1968). 29. Medical practice has become transformed in other ways as well which should have led to greater involvement of patients in the medical decision-making process: Medicine's recent ascent from empiricism to science has brought forth spectacular technologic advances in the diagnosis and treatment of disease. Today the numerous options available for the treatment of many diseases allow patients greater choice. Moreover, the introduction into medicine of scientific reasoning, aided by the results of carefully conducted research, permits doctors to be more discriminating between knowledge, ignorance and conjecture in their recommendations for or against a treatment. For the first time in medical history, it is possible, even medically and morally imperative, to give patients a voice in medical decision making; possible, because knowledge and ignorance can be better specified; medically imperative, because a variety of treatments are available, each of which can bestow benefits or inflict harm; morally imperative, because patients, depending on the lifestyle they wish [to lead) after treatment, must be given a choice. Duty and Caring, supra note 20, at 189. 30. The randomized clinical trial (ReT) is generally regarded as the gold standard for th
研究问题倾向于将人-患者客观化与治疗互动相比,它的作用要大得多,尽管在治疗环境中,当医生过多地关注床上身体的疾病而不是他们面前的人时,也会出现类似的客观化问题。临床研究的准备就绪继续被视为临床实践的延伸,两者同样基于数千年来希波克拉底对个体患者福利的承诺,忽视了医学科学时代以来医疗实践的转变。纵观大部分医学史,研究都局限于对创新治疗效果的床边仔细观察,以个体患者的利益为指导。另一方面,在当今世界,病人的利益可能会在不同程度上屈服于科学的利益。这种革命性的发展并没有伴随着对后罗马时代医生道德义务的彻底重新审视。这方面的例子是许多合作临床试验,通常是随机临床试验(rct),在27个国家的机构中。见下面说明66和所附案文。28. 在一名资深医师和一名医疗实习生的对话中,前者问实习生对“病人作为人”了解多少。这个问题导致了一场毫无成果的交流,最后这位实习生突然愤怒地说:“我无法回答你的问题。你对病人感兴趣。我对躺在床上的身体里的疾病感兴趣。”《疾病与社会》第128期(1968)。29. 医疗实践也在其他方面发生了变化,这应该导致患者更多地参与医疗决策过程:医学最近从经验主义上升到科学,在疾病的诊断和治疗方面带来了惊人的技术进步。今天,许多疾病的治疗方案众多,使患者有了更多的选择。此外,在仔细进行的研究结果的帮助下,将科学推理引入医学,使医生在建议或反对治疗时能够更好地区分知识、无知和猜测。在医学史上,第一次有可能,甚至在医学和道德上都是必要的,让病人在医疗决策中有发言权;可能,因为知识和无知可以更好地区分;在医学上是必要的,因为有各种各样的治疗方法,每一种都可以带来好处或造成伤害;道德上是必要的,因为病人必须根据他们希望在治疗后过的生活方式做出选择。职责和关怀,参见说明20,第189页。30.随机临床试验(ReT)通常被认为是评价治疗药物的金标准。ReT有四个主要元素。1)它是“受控的”,也就是说,一部分受试者接受正在测试的治疗,而另一部分则尽可能相似……,接受另一种治疗或不接受治疗....2)通过统计分析确立其结果的显著性.. ..3)可行时,双盲
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引用次数: 100
Moore v. Regents of the University of California: patients, property rights, and public policy. 摩尔诉加州大学校董会:病人、产权和公共政策。
Pub Date : 1991-01-01
K G Biagi
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引用次数: 0
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Saint Louis University law journal
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