Diabetic Foot Ulcer: Amputation on Request?

Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria

Ethical problems routinely arise in the hospital and outpatient practice settings and times of dilemma do occur such that practitioners and patients are at cross-roads where choice and decision making become difficult in terms of ethics. This paper attempts a synopsis of the basic principles of medical ethics, identifies some ethical dilemmas that doctors often encounter and discusses some strategies to address them as well as emphasizes the need for enhanced ethics education both for physicians and patients particularly in Nigeria. Literature and computer programmes (Medline and PsychoInfo databases) were searched for relevant information. The search showed that the fundamental principles suggested by ethicists to assist doctors to evaluate the ethics of a situation while making a decision include respect for autonomy, beneficence, non-maleficence and justice. Although the above principles do not give answers as to how to handle a particular situation, they serve as a guide to doct...

Australian and New Zealand journal of medicine, 1993

BJPsych Open, 2021

Aims Central and North West London's Clinical Ethics Committee (CEC) offers a non-judgmental space to discuss ethical concerns and challenges and provide ethical guidance. This project aims to publicise these ethical dilemmas and guidance to inform decision making trust-wide. Background A Clinical Ethics Committee (CEC) encompasses a diverse range of figures, from psychiatrists and general practitioners to members of the clergy and experts by experience. The CEC in Central and North West London have been meeting regularly since 2003 to provide ethical assistance to a wide range of medical, surgical and psychiatric teams. Complex ethical cases are presented by the treating team, allowing a subsequent discussion of the ethical theories and frameworks within the case with the committee members. This synthesis of information can then assist the treating team in the shaping of ethical based solutions to their dilemmas. The committee wished to encourage ethical based clinical thinking...

Medical Clinics of North America, 2002

Ethics is the application of values and moral rules to human activities. Bioethics applies ethical principles and decision making to solve actual or anticipated dilemmas in medicine. Much like clinical practice, which relies on general rules and case-based experiences, bioethical reasoning relies on learned and accepted moral rules, prior bioethical decisions derived from thoughtful reflection, and unique factors in each individual situation. This method of case-based reasoning is termed casuistry, although physicians better know it as clinical reasoning [1]. The term ethics in this article refers to normative ethics, a type of practical activity through which we try to determine what we ought to do and how our institutions should function. Contemporary medical ethics is a tapestry that interweaves a range of philosophical theories. The following four clusters of moral ''principles'' are central to medical ethics: (1) autonomy (respecting the decision-making capacities of individuals), (2) nonmaleficence (avoiding the causation of harm), (3) beneficence (providing benefits and balancing benefits against risk and costs), and (4) justice (the fair distribution of benefits, risks, and costs). Historically, nonmaleficence and beneficence have played a central role in medical ethics, whereas respect for autonomy and justice were neglected in traditional medical ethics but have come into prominence in the last 30 years [2]. Autonomy is the most significant value that has been promoted by contemporary medical ethics. The acknowledgment of autonomy has served to discredit medical paternalism and has led to the promotion of the patient from recipient of treatment to being the partner in a treatment plan. However, the acceptance of autonomy as the benchmark of good has led us to Med Clin N Am 86 (2002) 869-886

Instructional course lectures

Because our actions as physicians have far-reaching consequences, and because society allows us to do things to others that no one else is free to do, physicians' professional activities fall under the domain of ethical evaluation. We are charged with the obligation to use specialized scientific knowledge, to work in concert with others, and to act for the good of our patients. In fact, acting for the good of our patients is the central tenet of ethical medical behavior. What constitutes the good of the patient, however, is not always clear. In general, we act to limit disease, restore function, alleviate suffering, and prolong life. We understand fully, however, that these goals may conflict with one another. Judgment about what is right for a particular patient leads us to another crucial consideration of ethical behavior, namely, respect for patient autonomy. We recognize that individuals have the right to control their own destiny. Patients have a right, therefore, to make c...

Elizabeth Zubiate

Elective surgery is a procedure that is unnecessary and is done to prevent a condition that may or may not happen in the future. Some of these procedures include prophylactic mastectomies and elective amputations. The focus of this article is to discuss several ethical issues that ...

Journal of Inherited Metabolic Disease, 1988

Journal of the American College of Surgeons, 1999

Medicine, 2016

Law regulates many areas of medicine, so doctors should understand the legal framework within which they must work ethically. The UK Parliaments considers ethical principles when legislating on issues such as organ donation and abortion, and judges frequently consider ethical dilemmas in medicine. A new ethical perspective permeates medical law, illustrated by changed attitudes in Parliament and the courts, departing from assumptions based on paternalism and the view that the medical profession 'knows best', to recognizing the importance of patients' autonomy. This is notable in areas such as consent, treatment of patients lacking capacity, allocation of scarce resources, confidentiality, negligence, deprivation of liberty, organ donation, medical research, reproductive technologies and abortion. The new development was summed up by Lord Steyn, a senior judge: 'In modern law, medical paternalism no longer rules'. Thus, the law now requires doctors seeking consent to provide sufficient information to enable patients to agree to proposed treatment with appropriate knowledge of risks, adverse effects and possible alternatives. Central to this changed culture is the importance of good communication. This overview concentrates on describing legal process and reasoning in the context of medical practice, referring to cases where fundamental ethical values have guided legal decision-makers. More comprehensive guidance can be found in Further reading.