Biomedical subjects

George J Agich

Publications and source records attributed to George J Agich.

9 recordsLinked to original sources

PubMed2005

What kind of doing is clinical ethics?

This paper discusses the importance of Richard M. Zaner's work on clinical ethics for answering the question: what kind of doing is ethics consultation? The paper argues first, that four common approaches to clinical ethics -- applied ethics, casuistry, principlism, and conflict resolution cannot adequately address the nature of the activity that makes up clinical ethics; second, that understanding the practical character of clinical ethics is critically important for the field; and third, that the practice of clinical ethics is bound up with the normative commitments of medicine as a therapeutic enterprise.

Ethical Theory↗

PubMed2004

Facing the ethical questions in facial transplantation.

Explore the source record for details and available documents.

Cadaver↗

PubMed2003

Joining the team: ethics consultation at the Cleveland Clinic.

In this paper, I describe the development of ethics consultation services and their operation at the Cleveland Clinic; my own educational experiences and background and how I came to see the importance of setting and collaboration for successfully doing clinical ethics; the unique culture of the Cleveland Clinic and its influence on the ethics consultation services provided there; and, finally, the place of personal commitments and values on the conduct of ethics consultations. I stress the point that although philosophers (and perhaps other bioethicists without health professions training) are socialized and educated to do solitary work, successfully conducting ethics consultations requires relatively high levels of collaboration and cooperation that have not been sufficiently discussed. Although this paper is more a description than an analysis of the influence of institutional setting on ethics consultation, I would claim that attention to setting, either as the local scene of the consultation or the institutional and social framework, deserves more attention by bioethicists intent on understanding ethics consultation.

Ambulatory Care Facilities↗

PubMed2003

Extension of organ transplantation: some ethical considerations.

The concept of vital organ transplantation is critically analyzed by considering how traditional transplantation modifies the commitment to saving lives. Problems such as those associated with immunosuppression might seem to provide a compelling reason to oppose extension of transplantation to non-lifesaving situations. A closer examination, however, shows that immunosuppression does not present an intractable objection. For some organ transplants, such as the uterus, use of immunosuppression could be limited to the childbearing years. Complexities associated with assessment of quality of life are discussed using the example of hand transplantation. Assessment of success and functionality in a hand transplant is more complicated than it might appear at first. These complications suggest that monitoring and assessment should be a part of any extension of organ transplantation. Informed consent provides a limited, but important, component in justifying extended transplantation. Such justification, however, does not rest on patient autonomy, but on the reasonable prospect of benefit. Transplant programs considering an extension of traditional transplantation should develop formal protocols that include assessment of costs, benefits, quality of life, and the adequacy of informed consent.

Cost-Benefit Analysis↗

PubMed1999