Fortresses and formularies: drugs, ethics, and managed care.
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Ethics, Pharmacy↗
Biomedical subjects
A Jonsen
Publications and source records attributed to A Jonsen.
Basic curricular goals in medical ethics.
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Communication↗
The use of quality-of-life considerations in medical decision making.
Quality-of-life considerations in physicians' decisions on life-sustaining therapy were explored using a patient management problem (PMP) depicting acute respiratory failure in an elderly man with chronic pulmonary disease; 205 internal medicine and family medicine physicians were interviewed. The physicians' perceptions of the patient's quality of life demonstrated marked variability. Physicians considered the patient's quality of life more often to support decisions to withhold therapy than to support decisions to use mechanical ventilation (p less than 0.01). Consideration of quality of life was associated significantly with several PMP components: interpretation of the patient's prior medical experience, management of supplementary case information, attitudes about medical responsibilities/patient rights, and estimates of the patient's survival time. The authors conclude that consideration of quality of life in making life-and-death treatment decisions may involve judgments about the value of life, and that responsible consideration requires guidelines grounded in ethical principles.
Aged↗
Ethics and AIDS.
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Acquired Immunodeficiency Syndrome↗
Fetal treatment 1982.
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Congenital Abnormalities↗
Medical ethics and torture.
There is growing evidence of widespread use of torture among political prisoners throughout the world. Medical personnel frequently become involved, sometimes directly, sometimes peripherally as in the examination or treatment of such prisoners. Physicians themselves may become victims of torture when the state attempts to subvert the doctor-patient relation for political purposes. Furthermore, recent studies demonstrate long lasting medical and psychologic effects of torture. For these reasons, physicians have a special opportunity and ethical obligation to resist and oppose torture as well as to support physicians whose lives or professional careers are jeopardized by their refusal to participate in torture. Codes of medical ethics need strengthening to provide clear guidance for the physician who becomes aware of or actively involved in these brutal practices.
Aggression↗