Biomedical Ethics

2021 ◽  
pp. 169-188
Author(s):  
Thaddeus Metz

Chapter 9 addresses the duties of medical practitioners such as doctors and nurses, mostly in relation to patients, but also in respect of each other and their society. It argues that the relational moral theory is at least no worse than, and is often to be preferred over, more Western principles when it comes to how to understand several biomedical obligations. For example, the chapter maintains that the communal ethic makes good sense of whom a medical professional has moral reason to treat and for which purposes. It further contends that rightness as friendliness grounds moderate positions on abortion and euthanasia that many will find convincing but that utilitarianism and Kantianism have difficulty entailing and explaining. For example, if utilitarianism and Kantianism permit abortion, it is hard for them to avoid also permitting infanticide, but the relational ethic can more easily avoid that implication.

Author(s):  
James F. Childress ◽  
Tom L. Beauchamp

Abstract After briefly sketching common-morality principlism, as presented in Principles of Biomedical Ethics, this paper responds to two recent sets of challenges to this framework. The first challenge claims that medical ethics is autonomous and unique and thus not a form of, or justified or guided by, a common morality or by any external morality or moral theory. The second challenge denies that there is a common morality and insists that futile efforts to develop common-morality approaches to bioethics limit diversity and prevent needed moral change. This paper argues that these two critiques fundamentally fail because they significantly misunderstand their target and because their proposed alternatives have major deficiencies and encounter insurmountable problems.


Utilitas ◽  
2001 ◽  
Vol 13 (3) ◽  
pp. 342-349 ◽  
Author(s):  
Walter Sinnott-Armstrong

If there is a moral reason for A to do X, and if A cannot do X without doing Y, and if doing Y will enable A to do X, then there is a moral reason for A to do Y. This principle is plausible but mysterious, so it needs to be explained. It can be explained by necessary enabler consequentialism, but not by other consequentialisms or any deontological moral theory. Or so I argue. Frances Howard-Snyder objects that this argument fails to establish consequentialism as understood by ‘most philosophers’, because it fails to establish agent-neutrality. I respond by distinguishing consequentialism, which need not be agent-neutral, from utilitarianism, which claims agent-neutrality. Howard-Snyder also presents a schema for a non-consequentialist theory that is supposed to explain moral substitutability. I respond that her explanation cannot be completed without introducing incoherence into deontological moral theories.


Author(s):  
Melissa Contreras-Nourse

The interpreting profession has long used metaphors or rule statements to describe and teach the ways in which practitioners make decisions (Dean & Pollard, 2011, 2018). Interpreting students are also often taught that the context of an encounter will dictate their decision-making by way of statements such as “it depends”. Such pedagogical statements can make talk between a practitioner and a medical professional about the responsibilities of an interpreter during medical encounters difficult. This study is based on the work of Dean and Pollard (2011, 2018) on value-based decision-making and is guided by the four principles of biomedical ethics (respect for autonomy, non-maleficence, beneficence and justice). It has sought to provide evidence of the existence, applicability and usability of these frameworks through a single case study of a real-life appointment in which a parent of a palliative care outpatient and a medical professional communicated during a consultation, aided by a medical interpreter.


2021 ◽  
Author(s):  
Veena S Singaram ◽  
Kimesh Naidoo ◽  
Labby Ramrathan

Abstract Background Newly qualified medical practitioners (interns) in South Africa (SA) are part of the frontline healthcare workers who face Africa’s most severe COVID-19 pandemic within an environment already burdened with tuberculosis, HIV and trauma epidemics. The experiences of interns during the pandemic reflect SA’s preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts. This study explored the strengths, weaknesses, opportunities and threats posed by the COVID-19 pandemic as reflected on by interns within clinical training platforms in SA.Methods An online survey tool consisting of ten open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. Due to lockdown restrictions, all data were collected remotely with the survey instrument being distributed via the social media platform WhatsApp. Three coders thematically analysed data until consensus was reached.Results Forty-six first- and second-year interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, being in a learning environment, and specific learnings realised. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback and broadening the intern curriculum were identified. In addition, the use of online training around holistic care and intern evaluation was mooted as an innovation to develop out of this pandemic.Conclusion Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ali I. Alharbi ◽  
Valerie Gay ◽  
Mohammad J. AlGhamdi ◽  
Ryan Alturki ◽  
Hasan J. Alyamani

Medication errors related to medication administration done by both doctors and nurses can be considered a vital issue around the world. It is believed that systematisation and the introduction of main documents are done manually, which might increase the opportunities to have inaccuracies and errors because of unexpected wrong actions done by medical practitioners. Experts stated that the lack of pharmacological knowledge is one of the key factors, which play an important role in causing such errors. Doctors and nurses may face problems when they move from one unit to another and the medication administration list has changed. However, promoting public health activities and recent AI-enabled applications can provide general information about medication that helps both doctors and nurses administer the right medication. However, such an application can require a lot of time and effort to search and then find a medication. Therefore, this article aims to investigate whether AI-enabled applications can help avoid or at least minimize medication error rates.


Author(s):  
Zahra Ayubi

This chapter outlines Muslim ethics and practices surrounding the birth, care, and death of neonates, with special attention to gender dynamics in Muslim families. In the absence of unified Islamic law-making bodies that decide on issues of biomedical ethics, it is crucial to explore questions of authority over decision making, which is often a highly gendered issue. The central questions that arise in neonatal cases are: When is it appropriate to withdraw treatment? What rituals surround the births and deaths of neonates? and Who has the authority to make decisions? The author divides Muslim practices into two main paradigms: those based on scripturally dependent beliefs and those based on ritually dependent beliefs. It is important for medical practitioners to be aware of gendered concerns and differences between ethicolegal theory and ethical praxis in decision making in neonatal care. Muslim beliefs and practices cannot be reduced to texts.


1987 ◽  
Vol 13 ◽  
pp. 264-284 ◽  
Author(s):  
Susan Sherwin

New technology in human reproduction has provoked wide ranging arguments about the desirability and moral justifiability of many of these efforts. Authors of biomedical ethics have ventured into the field to offer the insight of moral theory to these complex moral problems of contemporary life. I believe, however, that the moral theories most widely endorsed today are problematic and that a new approach to ethics is necessary if we are to address the concerns and perspectives identified by feminist theorists in our considerations of such topics. Hence, I propose to look at one particular technique in the growing repertoire of new reproductive technologies, in vitro fertilization (IVF), in order to consider the insight which the mainstream approaches to moral theory have offered to this debate, and to see the difference made by a feminist approach to ethics.


2020 ◽  
Vol 42 (3) ◽  
pp. 698-716
Author(s):  
Toyin Ajibade Adisa ◽  
Emeka Smart Oruh ◽  
Babatunde Akanji

PurposeDespite the fundamental role of culture in an organisational setting, little is known of how organisational culture can be sometimes determined/influenced by professional culture, particularly in the global south. Using Nigeria as a research focus, this article uses critical discuss analysis to examine the link between professional and organisational culture.Design/methodology/approachThis study uses qualitative research approach to establish the significance of professional culture as a determinant of organisational culture among healthcare organisations.FindingsWe found that the medical profession in Nigeria is replete with professional duties and responsibilities, such as professional values and beliefs, professional rules and regulations, professional ethics, eagerness to fulfil the Hippocratic Oath, professional language, professional symbols, medicine codes of practice and societal expectations, all of which conflate to form medical professionals' values, beliefs, assumptions and the shared perceptions and practices upon which the medical professional culture is strongly built. This makes the medical professional culture stronger and more dominant than the healthcare organisational culture.Research limitations/implicationsThe extent to which the findings of this research can be generalised is constrained by the limited and selected sample of the research.Practical implicationsThe primacy of professional culture over organisational culture may have dysfunctional consequences for human resource management (HRM), as medical practitioners are obliged to stick to medical professional culture over human resources practices. Hence, human resources departments may struggle to cope with the behavioural issues that arise due to the dominant position taken by the medical practitioners. This is because the cultural system (professional culture), which is the configuration of beliefs, perceived values, code of ethics, practices and so forth. shared by medical doctors, subverts the operating system. Therefore, in the case of healthcare organisations, HRM should support and enhance the cultural system (the medical professional culture) by offering compatible operating strategies and practices.Originality/valueThis article provides valuable insights into the link between professional culture and organisational culture. It also enriches debates on organisational culture and professional culture. We, therefore, contend that a strong professional culture can overwhelm and eventually become an organisational culture.


2019 ◽  
Vol 15 (1) ◽  
pp. 1-14
Author(s):  
Flávio R. L. Paranhos Paranhos ◽  
Volnei Garrafa ◽  
Jan Helge Solbakk

Tom L. Beauchamp and James F. Childress have been increasingly using a moral theory known as “Theory of Common Morality” as a philosophical basis for their four principle approach to biomedical ethics, currently known as principlism. In the latest edition (2013) of their Principles of Biomedical Ethics, they acknowledge the contribution of some previous theorists of common morality. Bernard Gert, a critic of principlism, is one of them. The aim of this paper is to provide a critical analysis of Gert’s Theory of Common Morality, as developed in his book Common Morality. Deciding What to Do (2004). According to Gert, common morality is a moral system that everyone uses implicitly when making decisions and judgments. This system consists, basically, of moral rules, moral ideals and a two-step procedure used intuitively by every person to decide whether a given violation of a rule or ideal is legitimate. There are ten moral rules, which can be collapsed into two basic ones, Do not cause harm (Do not kill; Do not cause pain; Do not disable; Do not deprive of freedom; Do not deprive of pleasure), and Do not violate the trust (Do not deceive; Keep your promises; Do not cheat; Obey the law; Do your duty). Moral rules apply to moral agents, which are constituted by all humans able to fully understand the moral rules, as well as predict the consequences of their eventual violation. It is our understanding that, despite the highly intuitive appeal of Gert’s approach, as well as of Beauchamp and Childress’s, the Theory of Common Morality has some fundamental flaws which are discussed in the article.


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