Leonardo Botallo (1530–1587) and his pioneering contributions to traumatology, cardiology and deontology

Leonardo Botallo (1530–c. 1587) is widely known for the eponymous “foramen Botalli” and “ductus Botalli”. The first, most commonly named “foramen ovale”, allows blood in the fetal heart to enter the left atrium from the right atrium. The second, named “ductus arteriosus”, consists of a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. However, Botallo was a multifaceted figure who studied many aspects of human anatomy and physiology, also making important contributions to clinical and surgical practices. Moreover, as we will see in the last section of this paper, Botallo wrote a book on medical deontology having significant features in relationship to the history of medical ethics. Botallo’s multidisciplinary approach is a typical characteristic of Renaissance physicians and scientists, who contributed to making this period a fundamental prelude to the scientific revolution of the 17th century.

Ethics in obstetrics and gynaecology

Obstetrician-gynaecologists confront a wide range of ethical challenges in clinical practice. To guide obstetrician-gynaecologists in responding to these challenges in a responsible way, this chapter provides a concise overview based on the professional responsibility model of ethics in obstetrics and gynaecology. This model is based on the transformative contributions of Drs John Gregory (1724–1773) and Thomas Percival (1740–1804) to the global history of medical ethics. This model requires three commitments of physicians: to scientific and clinical competence; to the primacy of the patient’s health-related interests; and to sustaining medicine as a public trust rather than a self-interested merchant guild. This model emphasizes the professional virtues of doctors and ethical principles and the obligations to patients generated by these virtues and principles. The result is a model for ethics in obstetrics and gynaecology that is ethically sound and clinically comprehensive and practical. Taking a preventive ethics approach, this chapter provides ethically justified, practical guidance on the professional responsible management of clinical ethical challenges in gynaecology, in obstetrics, and in professionally responsible advocacy.

Ethical Issues in Treating Pain and Addiction (DRAFT)

In addressing the ethical issues that arise in treating both pain and addiction, the author of this chapter has organized his presentation around: the history of medical ethics; theories and definitions; and the ethical challenges to providing clinical care. The theoretical underpinnings to ethical decision-making are important to providing the best possible outcome, and their evolution is described, from the Hippocratic Oath to current human subjects’ protection rules for clinical trials. The tension between patient autonomy and the physician’s obligation to protect is as high as that seen in parenthood, but commonly with even less control of the individuals involved. A framework is provided for examining clinical cases that aids in addressing such topics as treatment disagreement, confidentiality, informed consent, abandonment, pregnancy, and biases that may be seen with categorical treatment programs (e.g., abstinence-based, faith-based). A text box is added giving additional resources on the topics discussed.

Moral delimma of Abortion

Abortion is the termination of pregnancy. Not many years ago majority of the people considered abortion a crime so disgusting that it was hardly mentioned in public. Abortion was the dramatic stuff of novels and movies portraying girls in trouble or women pushed to the brink. Times have changed somewhat. Abortion is now legal in the west. Yet controversy over the legitimacy of abortion continues to flare. In the history of medical ethics, no other topic has attracted more attention. The reason is clear. In the abortion issue, major moral, legal and social issues are intertwined to form a problem of great subtlety and complexity. This is a review article.

“Something of an Adventure”: Postwar NIH Research Ethos and the Guatemala STD Experiments

Since their revelation to the public, the sexually transmitted disease (STD) experiments in Guatemala from 1946 to 1948 have earned a place of infamy in the history of medical ethics. During these experiments, Public Health Service (PHS) researchers intentionally exposed over 1,300 non-consenting Guatemalan soldiers, prisoners, psychiatric patients, and commercial sex workers to gonorrhea, syphilis, and/or chancroid under conditions that have shocked the medical community and public alike. Expert analysis has found little scientific value to the experiments as measured by current or contemporaneous research standards.Such an obvious case of research malfeasance, which violated research norms in place both in the past and now, has been uniformly repudiated. The Guatemala STD experiments were labeled “clearly unethical” by President Barack Obama and “reprehensible” by the Secretaries of State and Health and Human Services.

Medical Ethics and the Law

This article reflects on some historiographical focal points and trends in the recent scholarly literature on the history of medical ethics and bioethics. It discusses historical relationships between normative thought and legal regulations. This analysis focuses on three key issues: the nature and motivations of traditional medical professional ethics; the history of ethical abuses in clinical experimentation and their consequences for regulation; and the rise of bioethics. The history of clinical experimentation has brought the ethics of the doctor–patient relationship into sharp relief. The issues surrounding human organ donation and transplantation that have become central to modern bioethics are also discussed. The conclusion of this article points to future directions in the historiography of medical ethics.

Informed Consent: Its History, Meaning, and Present Challenges

The practice of obtaining informed consent has its history in, and gains its meaning from, medicine and biomedical research. Discussions of disclosure and justified nondisclosure have played a significant role throughout the history of medical ethics, but the term “informed consent” emerged only in the 1950s. Serious discussion of the meaning and ethics of informed consent began in medicine, research, law, and philosophy only around 1972.