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PubMed1977

Some additional bioethical questions related to hepatitis B antigen.

Dr. Baruch S. Blumberg has recently raised important questions concerning the bioethics of prevention and cure of hepatitis. This paper extends his inquiry with a view toward examining the full range of the complexity of such issues as the restriction of the use of blood infected with hepatitis B antigen, the screening and possible isolation of health care personnel found to be carriers, and the like. It pointed out that for issues like these, there is not only a conflict between personal liberties and the public interest but also a potential conflict of individual rights, a theme not treated fully by Blumberg. The complex issues that emerge when these two themes are considered together are examined in light of the work of the contemporary American philosopher, John Rawls. His theory permits one to consider these two ethical themes together in analyzing moral problems. In this light, a new strategy is proposed for addressing bioethical questions concerning hepatitis B antigen.

Blood Donors↗
PubMed1978

Aging and the right to terminate medical treatment.

Belief in the right of patient and/or family to terminate medical care in the case of irreversible terminal illness is analyzed by age level, education, health, and attitudes to patient rights in general. The issue of terminating treatment has become important as the result of new technologies which permit continuance of bodily functions by mechanical means; stopping care involves confrontation with the norm of maintaining life at all costs. Although age is related to support of the right to halt treatment, with those over 65 least likely to agree, the style of relation to professional care in general has more explanatory power.

Adolescent↗
PubMed1977

When is a voluntary commitment really voluntary?

Cognitive disorganization limits a person's capacity to act voluntarily, because such action requires a significant degree of attention and comprehension. The compliance of a psychotic person who fails to understand his own actions may be construed by clinicans as voluntary behavior. This possible misuse of voluntary hospitalization is examined, and the employment of categories other than voluntary and involuntary is suggested.

Adult↗
PubMed1975

The limits of informed consent.

The patient, a 59-year-old man, was referred to a psychiatric hospital with what appeared initially to be the signs and symptoms of mental disorder. In hospital a lesion of the brain was diagnosed and surgery was proposed to relieve the condition. The patient, however, during this and subsequent admissions to hospital, refused operation. His refusal to consent was regarded as valid as he seemed to have good insight into his condition. Finally, under section 26 of the Mental Health Act, he was treated surgically. Unfortunately the patient died six weeks later of intracranial haemorrhage. Three comments are made on this case - two by psychiatrists, Dr K Davison and Dr Ashley Robin, the other by a professor of Christian ethics, Professor F C Blackie. Both psychiatrists argue that when a patient's mind is affected by mental or organic illness to the degree that 'he cannot bring a rational and conscious mind' to the question of his treatment then the doctor, in consultation with the relatives, making clear to them the likely course of events if an operation is not performed, must take whatever is the proper course of action, in this case surgery. In this view, such an operation performed immediately the diagnosis was confirmed might not have been so complicated. Professor Blackie, commending 'the attempt to regard the patient as a responsible human being' with a 'moral right to be consulted on all aspects of treatment', questions in this patient the limits to which the appeal to reason was carried. He concludes that 'in this situation the advice and consent of the family must weigh more heavily than the statements of the patient'.

Antipsychotic Agents↗
PubMed1977

Royal College of Nursing (Rcn) code of professional conduct: a discussion document.

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document.

Codes of Ethics↗