Autonomy in Medical Ethics: Issues of Informed Consent

Author(s):  
Maartje Schermer
2007 ◽  
Vol 18 (2) ◽  
pp. 225-247 ◽  
Author(s):  
Andrew Clifford

This article examines the part that healthcare interpreters play in cross-cultural medical ethics, and it argues that there are instances when the interpreter needs to assume an interventionist role. However, the interpreter cannot take on this role without developing expertise in the tendencies that distinguish general communication from culture to culture, in the ethical principles that govern medical communication in different communities, and in the development of professional relationships in healthcare. The article describes each of these three variables with reference to a case scenario, and it outlines a number of interventionist strategies that could be potentially open to the interpreter. It concludes with a note about the importance of the three variables for community interpreter training. Keywords: community interpreting, informed consent, role of the interpreter, healthcare.


2019 ◽  
Vol 45 (12) ◽  
pp. 826-827 ◽  
Author(s):  
Florence Ashley

In a previous article, I argued that assessment requirements for transgender hormone replacement therapy (HRT) are unethical and dehumanising. A recent response published by the Journal of Medical Ethics criticises this proposal. In this reply, I advance that their response misunderstood core parts of my argument and fails to provide independent support for assessment requirements. Though transition-related care may have similarities with cosmetic surgeries, this does not suffice to establish a need for assessments, and nor do the high rates of depression and anxiety justify assessments, especially given the protective role HRT plays towards mental well-being.


Author(s):  
Madhu Nagla

The purpose of this paper is to provide an historical overview of the developments in the field of ethics concerning medicine and health. The discourse also focuses on morals and ethics. We summarize major principles around which much of ethics debates concerning medical and health care have been organized. Following this our paper connects the medical ethics in India with the contemporary concern. The present paper is divided into two parts. The first part attempts to discuss historical development of medical ethics at global level. In particular, western philosophy has been profoundly shaped by three theories of ethics: Aristotelianism, deontology and utilitarianism. Each of these three theories can in turn be seen as essentially a product of the times in which it was originally born. The medical ethics have come a long way and still a continuing process. Ethical discourse is generated out of and applied in local worlds, however, so that it gets taken up in moral processes that are inseparable from local elations and conditions. The discourse of ethics and moral concludes that they are inseparable from local relations and conditions and at the same times aspires for trans-local perspective. Importantly, the four principles of ethics i.e. , autonomy, beneficence, non-maleficence, and justice) are prima facie and binding for each individual to follow. In the second part of paper, an effort has also been made to discuss the historical aspects of medical ethics in India. Medical ethics are not merely a moral code but a legally sanctioned code of conduct acceptable and normal within the medical profession. A broad range of issues can be covered under the rubric of ethical issues, however, specific concerns related to the globalization, equity in health, technology and ethics, informed consent, emergency and health care and reproduction are the major concern of ethics. The ideas enshrined in the doctrine of informed consent though not legally binding yet, continue to percolate into the medical and lay discourse. The doctrine of informed consent is complicated and needs to be addressed in socio-cultural and other constraints of the society. Advances in bio-sciences and bio-technology, such as surrogacy, sex selection, genetics etc. widened the scope of medical ethics. Ethics are the bridge between health policy and values. Health policy is related with the equity and justice to its people in receiving the health care, and thus medical ethics examines the moral validity of it. There is a need to develop an ethical culture in society. Ethics, equity and respect for humanity must be incorporated in all aspects of health care. Ethics has to be institutionalized wherever it is needed. Given the events of the last decades it is a sad reality that at least in the Indian health care set up ethics are losing their sight and has been moving towards commercialization than science and healing.


2005 ◽  
Vol 33 (4) ◽  
pp. 791-801 ◽  
Author(s):  
Paul A. Lombardo

Over the past thirty years, the doctrine of informed consent has become a focal point in discussions of medical ethics. The literature of informed consent explores the evolution of the principle of autonomy, purportedly emerging from the mists of 19th Century medical practice, and finding its earliest articulation in legal cases where wronged citizens asserted their rights against medical authority. A commonplace, if not obligatory, feature of that literature is a reference to the case of Mary Schloendorff and the opinion written by Judge Benjamin Cardozo by which the case is remembered. Commentators today applaud the prescience of Cardozo for an early articulation of what eventually would become bioethical orthodoxy concerning informed consent and its place as a bulwark of patient autonomy. They inevitably quote Cardozo's famous statement, “Every human being of adult years and sound mind has a right to determine what shall be done with his own body.”


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