Biomedical subjects
W H Bruening
Publications and source records attributed to W H Bruening.
Concurrent care: an ethical issue for family physicians.
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Autonomy and futility.
One of the underlying ethical values of the Patient Self-Determination Act (PSDA) is the legal right of patients to decide on their own medical care, i.e., to accept or refuse medical treatment. Yet, there is a growing concern that a patient's legal right to determine medical treatment might result in health care professionals violating their own personal and/or professional ethical values. I shall therefore briefly review the requirements of the PSDA and outline the consequences of this act for a particular case. The application of the Act becomes problematic in this case because the health care professionals involved believe that the treatments involved are medically futile. I consider the potential conflict between autonomy and futility. The thesis defended is that patient autonomy is not an absolute moral right and that health care professionals are not only permitted, but are sometimes morally required, to withhold and/or withdraw futile treatments even if the patient or the patient's surrogate request (demand!) that the treatments be continued.
Point and counterpoint. Should HECs consider financial costs of care during case review? A reply.
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Point and counterpoint. A response to White and Gottlieb.
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Teaching ethics to nurses.
Educating nurses about ethics is more complex, multidimensional, and time consuming than educating nurses about technical skills. Many factors, including the ability of the nurse to view situations holistically, the moral development of the nurse, and the institution's ethics, are involved. To illustrate how to teach nurses ethics, two examples of programs are detailed in this article.
Patient-centered conference.
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Educating the ethics committee.
Ethics committees are being formed in all types of institutions. Education is the foundation of a functioning committee. The purpose of the education is to prepare the multidisciplinary committee members to deal with difficult ethical issues in a changing healthcare environment. In this article, the authors address different methodologies that can be used for educating ethics committees.